Objective:

To explore the overlap between neurosyphilis and autoimmune limbic encephalitis, emphasizing diagnostic and treatment strategies and their clinical significance.

Key Findings:

• Neurosyphilis can mimic the clinical presentation of limbic encephalitis, including psychiatric disturbances, cognitive impairment, and seizures, as evidenced by specific case studies.
• Cerebrospinal fluid analyses often show inflammatory characteristics consistent with both infectious and autoimmune processes, highlighting the diagnostic challenge.
• Limited observations suggest modest improvement with antimicrobial treatment alone, with more significant recovery following immunomodulation, indicating the need for a dual approach.

Interpretation:

The findings indicate a potential overlap between neurosyphilis and autoimmune limbic encephalitis, complicating diagnosis and treatment, with significant implications for clinical practice.

Limitations:

• The rarity of cases and reliance on case-based data limit the generalizability of findings, introducing potential biases.
• Variability in clinical presentations and diagnostic criteria may affect the synthesis of results, necessitating caution in interpretation.

Conclusion:

A dual diagnostic approach is recommended to ensure appropriate antimicrobial coverage while facilitating prompt autoimmune phenotyping and treatment escalation, defined by specific clinical and laboratory criteria.