Neurosyphilis pathophysiology: Difference between revisions
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==Overview== | ==Overview== | ||
Neurosyphilis is caused by [[Treponema pallidum]], the bacteria that cause syphilis. It usually occurs about 10 - 20 years after a person is first infected with syphilis. Not everyone who has syphilis will develop this complication. | Neurosyphilis is caused by [[Treponema pallidum]], the bacteria that cause [[syphilis]]. It usually occurs about 10 - 20 years after a person is first infected with [[syphilis]]. Not everyone who has [[syphilis]] will develop this complication. | ||
==Pathophysiology== | ==Pathophysiology== | ||
* | * Neurosyphilis is a manifestation of invasion of [[treponema pallidum]] [[Spirochaete|spirochete]]<nowiki/>s to the brain and [[Dorsal column|dorsal column of spinal cord]] in [[tertiary syphilis]].<ref name="pmid10194456">{{cite journal| author=Singh AE, Romanowski B| title=Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. | journal=Clin Microbiol Rev | year= 1999 | volume= 12 | issue= 2 | pages= 187-209 | pmid=10194456 | doi= | pmc=88914 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10194456 }} </ref><ref name="pmid17235095">{{cite journal| author=French P| title=Syphilis. | journal=BMJ | year= 2007 | volume= 334 | issue= 7585 | pages= 143-7 | pmid=17235095 | doi=10.1136/bmj.39085.518148.BE | pmc=1779891 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17235095 }} </ref> | ||
* Neurosyphilis usually occurs in patients who have untreated [[syphilis]] for a long time, usually about 10 to 20 years after first infection by [[treponema pallidum]] | * Neurosyphilis usually occurs in patients who have untreated [[syphilis]] for a long time, usually about 10 to 20 years after first infection by [[treponema pallidum]] | ||
* Only 25%–40% of persons who are not treated with [[penicillin]] will develop neurosyphilis. | * Only 25%–40% of persons who are not treated with [[penicillin]] will develop neurosyphilis. | ||
The forms of presentation of neurosyphilis can be grouped in two categories:<ref name="pmid12235572">{{cite journal| author=Conde-Sendín MA, Hernández-Fleta JL, Cárdenes-Santana MA, Amela-Peris R| title=[Neurosyphilis: forms of presentation and clinical management]. | journal=Rev Neurol | year= 2002 | volume= 35 | issue= 4 | pages= 380-6 | pmid=12235572 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12235572 }} </ref> | The forms of presentation of neurosyphilis can be grouped in two categories:<ref name="pmid12235572">{{cite journal| author=Conde-Sendín MA, Hernández-Fleta JL, Cárdenes-Santana MA, Amela-Peris R| title=[Neurosyphilis: forms of presentation and clinical management]. | journal=Rev Neurol | year= 2002 | volume= 35 | issue= 4 | pages= 380-6 | pmid=12235572 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12235572 }} </ref> | ||
# Early (asymptomatic, meningeal and meningovascular neurosyphilis) | # Early ([[asymptomatic]], [[Meninges|meningeal]] and meningovascular neurosyphilis) | ||
# late (progressive general paralysis and tabes dorsalis). | # late (progressive general paralysis and [[Tabes Dorsalis|tabes dorsalis]]). | ||
Other less important forms are: | Other less important forms are: | ||
* Gummas | * Gummas | ||
Revision as of 14:14, 26 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
Neurosyphilis is caused by Treponema pallidum, the bacteria that cause syphilis. It usually occurs about 10 - 20 years after a person is first infected with syphilis. Not everyone who has syphilis will develop this complication.
Pathophysiology
- Neurosyphilis is a manifestation of invasion of treponema pallidum spirochetes to the brain and dorsal column of spinal cord in tertiary syphilis.[1][2]
- Neurosyphilis usually occurs in patients who have untreated syphilis for a long time, usually about 10 to 20 years after first infection by treponema pallidum
- Only 25%–40% of persons who are not treated with penicillin will develop neurosyphilis.
The forms of presentation of neurosyphilis can be grouped in two categories:[3]
- Early (asymptomatic, meningeal and meningovascular neurosyphilis)
- late (progressive general paralysis and tabes dorsalis).
Other less important forms are:
- Gummas
- Ocular forms
- Syphilitic amyotrophy or hypoacusis
There are four different forms of neurosyphilis:
- Asymptomatic (most common form)
- General paresis
- Meningovascular
- Tabes dorsalis
Asymptomatic neurosyphilis occurs before symptomatic syphilis.
References
- ↑ Singh AE, Romanowski B (1999). "Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features". Clin Microbiol Rev. 12 (2): 187–209. PMC 88914. PMID 10194456.
- ↑ French P (2007). "Syphilis". BMJ. 334 (7585): 143–7. doi:10.1136/bmj.39085.518148.BE. PMC 1779891. PMID 17235095.
- ↑ Conde-Sendín MA, Hernández-Fleta JL, Cárdenes-Santana MA, Amela-Peris R (2002). "[Neurosyphilis: forms of presentation and clinical management]". Rev Neurol. 35 (4): 380–6. PMID 12235572.