General paresis of the insane: a case with MR imaging.

We describe the case of a 36-year-old man presenting with cognitive impairment and personality change. General paresis of the insane, the chronic cerebral parenchymatous form of neurosyphilis, was diagnosed. MRI showed the typical severe frontotemporal atrophy. Despite antibiotic treatment his mental state further declined. General paresis is rare and diagnosis is difficult because of the non-specific neuropsychiatric symptoms. Early diagnosis and treatment are important.