Neurosyphilis pathophysiology
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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
- It is understood that neurosyphilis is caused by Brain and spinal cord invasion of treponema pallidum infection.[1]
- Neurosyphilis is a manifestation of invasion of treponema pallidum spirochetes to the brain and dorsal column of spinal cord in tertiary syphilis.[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
- ↑ French P (2007). "Syphilis". BMJ. 334 (7585): 143–7. doi:10.1136/bmj.39085.518148.BE. PMC 1779891. PMID 17235095.
- ↑ 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.
- ↑ 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.