Neurosyphilis

Neurosyphilis refers to the infection of the brain and spinal cord by the syphilis bacteria. This can lead to destruction in many areas of the nervous system, causing loss of function of a person's arms or legs, loss of vision, and altered mental abilities. Neurosyphilis can affect many different body systems and may develop over an extended period of time. Symptoms of neurosyphilis usually include:

  • Personality changes, such as confusion and irritability.
  • Hearing loss.
  • Vision problems.
  • Decreased ability to concentrate.
  • Memory loss.
  • Difficulty speaking or understanding speech.
  • Tremor of the fingers and lips.
  • Mild headaches.
  • Disorderly appearance.

Other symptoms may include:

  • A wide gait.
  • Numbness or tingling of the hands or feet.
  • Muscle pain.
  • Joint destruction because of lack of sensation (Charcot's joint).
  • Inability to control urine or stool (urinary or fecal incontinence).

Neurosyphilis is divided into two major categories based on the areas of the nervous system affected.1

  • Meningovascular neurosyphilis affects small blood vessels of the outer membrane covering of the brain (meninges), brain, and spinal cord leading to tissue death.
  • Parenchymatous neurosyphilis refers to the destruction of nerve cells in the brain and spinal cord leading to partial paralysis and pain, urinary incontinence, difficulty walking, balance problems, and vision problems.

Most forms of neurosyphilis take years to develop and can be life-threatening. Meningovascular neurosyphilis usually develops from 5 to 12 years after the initial syphilis infection and is most commonly seen in people from 30 to 50 years of age. Parenchymatous neurosyphilis usually develops in 15 to 25 years.2 People who are also infected with human immunodeficiency virus (HIV) tend to develop signs of neurosyphilis sooner.

Antibiotic treatment cures the syphilis infection and stops the progress of neurosyphilis. But the damage that has already occurred may not be reversed.

Citations

  1. Tramont EC (2005). Treponema pallidum (syphilis). In GL Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 6th ed., vol. 2, pp. 2768–2785. Philadelphia: Elsevier.
  2. Augenbraun M (2006). Syphilis and the nonvenereal treponematoses. In DC Dale, DD Federman, eds., ACP Medicine, section 7, chap. 6. New York: WebMD.

Last Updated: September 30, 2009

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