Neurosyphilis history and symptoms
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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
The late forms of neurosyphilis (tabes dorsalis and general paresis) are seen much less frequently since the advent of antibiotics. The most common manifestations today are asymptomatic or symptomatic meningitis. Clinical signs of neurosyphilis (i.e., cranial nerve dysfunction, meningitis, stroke, acute or chronic altered mental status, loss of vibration sense, and auditory or ophthalmic abnormalities) warrant further investigation and treatment for neurosyphilis.
History and Symptoms
History
Patients with tabes dorsalis may have a positive history of:
- Unprotected sexual activity
- HIV infection
- Immunocompromised state
- Immunosuppressive therapy
- Substance abuse
- Positive history of long-term untreated syphilis disease[1]
Common Symptoms
The symptoms of neurosyphilis usually develop secondary to long-term untreated syphilis, and include: Common symptoms of based on the classification include:
- Cranial nerve dysfunction symptoms:
- Diplopia[2]
- Impaired vision[3]
- Hearing loss[4]
- Voice changes[5]
- Meningitis symptoms (neurosyphilis can cause both symptomatic and asymptomatic meningitis):[1][6][7][8]
- Persistent headache
- Dizziness
- Vertigo
- nausea and vomiting
- photophobia
- Symptoms of spinal cord involvement (tabes dorsalis):
- Lightning pains[9]
- Impaired sensation and proprioception[10]
- Hypesthesias[11]
- Symptoms of cerebral syphilitic gumma:[12][13][14]
The symptoms of tabes dorsalis typically occurs 10 to 30 years after primary infection by treponema pallidum.[15]
Less Common Symptoms
Less common symptoms of neurosyphilis include:[16][17]
- Psychosis
- Depression
- Mania
- Cranial nerve abnormalities especially the optic nerve, facial nerve, and the vestibulocochlear nerve.
References
- ↑ 1.0 1.1 Kolar OJ, Burkhart JE (1977). "Neurosyphilis". Br J Vener Dis. 53 (4): 221–5. PMC 1045401. PMID 336144.
- ↑ Jordan K, Marino J, Damast M (1978). "Bilateral oculomotor paralysis due to neurosyphilis". Ann Neurol. 3 (1): 90–3. doi:10.1002/ana.410030114. PMID 655658.
- ↑ Smith GT, Goldmeier D, Migdal C (2006). "Neurosyphilis with optic neuritis: an update". Postgrad Med J. 82 (963): 36–9. doi:10.1136/pgmj.2004.020875. PMC 2563717. PMID 16397078.
- ↑ Nadol JB (1975). "Hearing loss of acquired syphilis: diagnosis confirmed by incudectomy". Laryngoscope. 85 (11 pt 1): 1888–97. doi:10.1288/00005537-197511000-00012. PMID 1195972.
- ↑ Klein TA, Ridley MB (2014). "An old flame reignites: vagal neuropathy secondary to neurosyphilis". J Voice. 28 (2): 255–7. doi:10.1016/j.jvoice.2013.08.018. PMID 24315656.
- ↑ Ahsan S, Burrascano J (2015). "Neurosyphilis: An Unresolved Case of Meningitis". Case Rep Infect Dis. 2015: 634259. doi:10.1155/2015/634259. PMC 4446468. PMID 26075118.
- ↑ Ghanem KG (2010). "REVIEW: Neurosyphilis: A historical perspective and review". CNS Neurosci Ther. 16 (5): e157–68. doi:10.1111/j.1755-5949.2010.00183.x. PMID 20626434.
- ↑ Berger JR, Dean D (2014). "Neurosyphilis". Handb Clin Neurol. 121: 1461–72. doi:10.1016/B978-0-7020-4088-7.00098-5. PMID 24365430.
- ↑ MAO S, LIU Z (2009). "Neurosyphilis manifesting as lightning pain". Eur J Dermatol. 19 (5): 504–6. doi:10.1684/ejd.2009.0712. PMID 19487174.
- ↑ Vora SK, Lyons RW (2004). "The medical Kipling--syphilis, tabes dorsalis, and Romberg's test". Emerg Infect Dis. 10 (6): 1160–2. doi:10.3201/eid1006.031117. PMC 3323152. PMID 15224672.
- ↑ Pandey S (2011). "Magnetic resonance imaging of the spinal cord in a man with tabes dorsalis". J Spinal Cord Med. 34 (6): 609–11. doi:10.1179/2045772311Y.0000000041. PMC 3237288. PMID 22330117.
- ↑ Li JC, Mahta A, Kim RY, Saria M, Kesari S (2012). "Cerebral syphilitic gumma: a case report and review of the literature". Neurol Sci. 33 (5): 1179–81. doi:10.1007/s10072-011-0878-8. PMID 22167653.
- ↑ Yoon YK, Kim MJ, Chae YS, Kang SH (2013). "Cerebral syphilitic gumma mimicking a brain tumor in the relapse of secondary syphilis in a human immunodeficiency virus-negative patient". J Korean Neurosurg Soc. 53 (3): 197–200. doi:10.3340/jkns.2013.53.3.197. PMC 3638277. PMID 23634274.
- ↑ Lee CW, Lim MJ, Son D, Lee JS, Cheong MH, Park IS; et al. (2009). "A case of cerebral gumma presenting as brain tumor in a human immunodeficiency virus (HIV)-negative patient". Yonsei Med J. 50 (2): 284–8. doi:10.3349/ymj.2009.50.2.284. PMC 2678706. PMID 19430565.
- ↑ Schöfer H (2004). "[Syphilis. Clinical aspects of Treponema pallidum infection]". Hautarzt. 55 (1): 112–9. doi:10.1007/s00105-003-0608-0. PMID 14749871.
- ↑ Kohler CG, Pickholtz J, Ballas C (2000). "Neurosyphilis presenting as schizophrenialike psychosis". Neuropsychiatry Neuropsychol Behav Neurol. 13 (4): 297–302. PMID 11186166.
- ↑ Wahab S, Md Rani SA, Sharis Othman S (2013). "Neurosyphilis and psychosis". Asia Pac Psychiatry. 5 Suppl 1: 90–4. doi:10.1111/appy.12050. PMID 23857843.