Neurosyphilis pathophysiology: Difference between revisions
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* Ocular forms | * Ocular forms | ||
* Syphilitic [[amyotrophy]] or hypoacusis\ | * Syphilitic [[amyotrophy]] or hypoacusis\ | ||
* | |||
* In tabes dorsalis, the preganglionic portion of the dorsal roots of spinal nerves is infiltrated with [[Lymphocyte|lymphocytes]] and [[plasma cells]], and invasion of [[treponema pallidum]] [[Spirochaete|spirochete]]<nowiki/>s to [[Posterior column|posterior columns]] of the [[spinal cord]] makes it [[Atrophy|atrophic]].<ref name="pmid21694502">{{cite journal| author=Carlson JA, Dabiri G, Cribier B, Sell S| title=The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity. | journal=Am J Dermatopathol | year= 2011 | volume= 33 | issue= 5 | pages= 433-60 | pmid=21694502 | doi=10.1097/DAD.0b013e3181e8b587 | pmc=3690623 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21694502 }} </ref> | |||
* The [[demyelination]] of the [[Axoneme|axones]] of the [[neurons]] is the main cause of symptoms and it affects the [[neurons]] in the [[Dorsal root ganglion|dorsal root ganglia]] and [[Posterior columns|posterior columns of the spinal cord]].<nowiki/><ref name="pmid21694502">{{cite journal| author=Carlson JA, Dabiri G, Cribier B, Sell S| title=The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity. | journal=Am J Dermatopathol | year= 2011 | volume= 33 | issue= 5 | pages= 433-60 | pmid=21694502 | doi=10.1097/DAD.0b013e3181e8b587 | pmc=3690623 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21694502 }} </ref> | |||
==References== | ==References== | ||
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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 which is the most common form, meningeal and meningovascular neurosyphilis)
- late (progressive general paralysis and tabes dorsalis).
Other less important forms are:
- Gummas
- Ocular forms
- Syphilitic amyotrophy or hypoacusis\
- In tabes dorsalis, the preganglionic portion of the dorsal roots of spinal nerves is infiltrated with lymphocytes and plasma cells, and invasion of treponema pallidum spirochetes to posterior columns of the spinal cord makes it atrophic.[4]
- The demyelination of the axones of the neurons is the main cause of symptoms and it affects the neurons in the dorsal root ganglia and posterior columns of the spinal cord.[4]
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.
- ↑ 4.0 4.1 Carlson JA, Dabiri G, Cribier B, Sell S (2011). "The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity". Am J Dermatopathol. 33 (5): 433–60. doi:10.1097/DAD.0b013e3181e8b587. PMC 3690623. PMID 21694502.