Syphilitic optic perineuritis.

We examined a patient who had syphilitic perioptic neuritis, a rarely diagnosed inflammation of the sheaths of the optic nerves that may be confused with papilledema caused by brain tumor or pseudotumor cerebri. The visual acuity was typically normal, and the only visual-field abnormality was enlargement of the blind spots. After we excluded an intracranial mass lesion, the diagnosis was confirmed by cerebrospinal fluid serologic findings positive for syphilis and normal intracranial pressure. Anti-inflammatory and antisyphilitic therapy resolved all the symptoms in our patient.