To investigate the clinical charateristics of neurosyphilis presenting with epileptic seizures.

Clinical, imaging and electroencephalogram (EEG) data of 21 patients of neurosyphilis presenting with seizures and admitted by the Department of Neurology in Beijing Ditan Hospital, Capital Medical University from August 2014 to May 2019 were analyzed, retrospectively.

The number (20 patients) of men in the enrolled patients had a superiority; there were 14 patients with local onset seizures (9 patients among whom with local to bilateral tonic-clonic seizures), 4 patients with unknown onset tonic-clonic seizures, 1 patient with convulsive status epilepticus and unknown source, 2 patients with manifest electrographic seizure only. Forteen patients were paralytic dementia, the rest were meningeal meningitis type (4 patients), meningeal vascular type (2 patients) and gum type (1 patients). The interictal EEG showed slow wave rhythm, epileptic wave and sphenoid electrode phase inversion or normal. A total of 16 patients were followed up, 10 patients among whom had no seizures.

Among the manifestation of patients with epileptic seizures and mental symptoms, neurosyphilis should be considered in diagnosis. Early detection and active treatment could improve the prognosis.