Neurosyphilis in the modern era

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dc.contributor.authorTimmermans M.
dc.contributor.authorCarr J.
dc.date.accessioned2011-05-15T16:17:04Z
dc.date.available2011-05-15T16:17:04Z
dc.date.issued2004
dc.description.abstractObjective: To review the nature of the presentation of neurosyphilis, the value of diagnostic tests, and the classification of the disease. Methods: A retrospective review was carried out of the records of patients who had been identified as possible cases of neurosyphilis by a positive FTA-abs test in the CSF. The review extended over 10 years at a single hospital which served a population of mixed ancestry in a defined catchment area in the Western Cape province of South Africa. Patients were placed in predefined diagnostic categories, and clinical, radiological, and laboratory features were assessed. Results: 161 patients met diagnostic criteria for neurosyphilis: 82 presented with combinations of delirium and dementia and other neuropsychiatric conditions, and the remainder had typical presentations such as stroke (24), spinal cord disease (15), and seizures (14). The average age of presentation ranged from 35.9 to 42.0 years in the different categories of neurosyphilis. Of those followed up, 77% had residual deficits from their initial illness. Cerebrospinal fluid (CSF) VDRL was positive in 73% of cases. Conclusions: The diagnosis of neurosyphilis can be made with reasonable certainty if there is an appropriate neuropsychiatric syndrome associated with a positive CSF VDRL. If the VDRL is negative, a positive FTA-abs in an appropriate clinical setting, associated with raised CSF cell count, protein, or IgG index, is a useful method of identifying neurosyphilis. Tabes dorsalis has become uncommon, but this is likely to be the only manifestation of neurosyphilis that has been altered during the antibiotic era.
dc.description.versionReview
dc.identifier.citationJournal of Neurology, Neurosurgery and Psychiatry
dc.identifier.citation75
dc.identifier.citation12
dc.identifier.issn00223050
dc.identifier.other10.1136/jnnp.2004.031922
dc.identifier.urihttp://hdl.handle.net/10019.1/14058
dc.subjectantibiotic agent
dc.subjectimmunoglobulin G
dc.subjectpenicillin G
dc.subjectantibiotic therapy
dc.subjectcerebrospinal fluid level
dc.subjectdelirium
dc.subjectdementia
dc.subjectdiagnostic test
dc.subjectdiagnostic value
dc.subjectdisease classification
dc.subjectfluorescent treponema antibody test
dc.subjecthuman
dc.subjectlaboratory diagnosis
dc.subjectneuropsychiatry
dc.subjectneurosyphilis
dc.subjectpriority journal
dc.subjectprotein cerebrospinal fluid level
dc.subjectretrospective study
dc.subjectreview
dc.subjectseizure
dc.subjectSouth Africa
dc.subjectspinal cord disease
dc.subjectstroke
dc.subjecttabes dorsalis
dc.subjectvenereal disease reaction test
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAge of Onset
dc.subjectBrain
dc.subjectDelirium
dc.subjectDementia
dc.subjectDiagnosis, Differential
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNeurosyphilis
dc.subjectRetrospective Studies
dc.subjectSeizures
dc.subjectSouth Africa
dc.subjectSpinal Cord Diseases
dc.subjectTomography, X-Ray Computed
dc.titleNeurosyphilis in the modern era
dc.typeReview
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