Section of human skull damaged by late stages of neurosyphilis.
Neurosyphilis is an infection of the brain or spinal cord caused by the spirocheteTreponema pallidum. It usually occurs in people who have had chronic, untreated syphilis, usually about 10 to 20 years after first infection and develops in about 25%–40% of persons who are not treated. The United States' Centers for Disease Control and Prevention (CDC) advises that neurosyphilis can occur at any stage of a syphilis infection.
Visual disturbances. There may be the sign of Argyll Robertson pupils, which are bilateral small pupils that constrict when the patient focuses on a near object, but do not constrict when exposed to bright light.
Upon further diagnostic workup, the following signs may be present:
In addition to evaluation of any symptoms and signs, various blood tests can be done:
Follow-up blood tests are generally performed at 3, 6, 12, 24, and 36 months to make sure the infection is gone. Lumbar punctures for CSF fluid analysis are generally performed every 6 months.
Neurosyphilis was almost at the point being unheard of in the United States after penicillin therapy was introduced. However, concurrent infection of T. pallidum with human immunodeficiency virus has been found to affect the course of syphilis. Syphilis can lie dormant for 10 to 20 years before progressing to neurosyphilis, but HIV may accelerate the rate of the progress. Also, infection with HIV has been found to cause penicillin therapy to fail more often. Therefore, neurosyphilis has once again been prevalent in societies with high HIV rates and limited access to penicillin.
^ abcdefg"Neurosyphilis". A.D.A.M. Medical Encyclopedia on PubMed Health. Reviewed by David C. Dugdale, Jatin M. Vyas, David Zieve. 6 October 2012. Retrieved 2014-10-23.
^ abcdMehrabian, S.; Raycheva, M.; Traykova, M.; Stankova, T.; Penev, L.; Grigorova, O.; Traykov, L. (20 September 2012). "Neurosyphilis with dementia and bilateral hippocampal atrophy on brain magnetic resonance imaging". BMC Neurology12 (1): 96. doi:10.1186/1471-2377-12-96.
^ abKennard, Christine (10 September 2014). "Neurosyphilis". About.com. Retrieved 2014-10-23.
^Murray, E. D.; Buttner, N.; Price, B. H. (2012). "Depression and Psychosis in Neurological Practice". In Bradley, W. G.; Daroff, R. B.; Fenichel, G. M. et al. Bradley's Neurology in Clinical Practice: Expert Consult1 (6 ed.). Philadelphia, PA: Elsevier/Saunders. pp. 101–102. ISBN1-4377-0434-4.|displayeditors= suggested (help)
^Musher, D. M. (1 June 1991). "Syphilis, Neurosyphilis, Penicillin, and AIDS". Journal of Infectious Diseases163 (6): 1201–1206. doi:10.1093/infdis/163.6.1201.