Neurosyphilis. A study of 241 patients

Abstract

The diagnosis of neurosyphilis is difficult due to lack of an ideal infallible laboratory test, the obscurity of the clinical symptoms, the rising incidence of its atypical forms, and the well-known occurrence of nontreponemal seronegative neurosyphilis.1 The incidence of neurosyphilis cannot be accurately assessed since venereal diseases remain vastly underreported. The problem has become more complicated by the fact that penicillin therapy in the first and second stages (infectious stages) of syphilis has altered the clinical picture of neurosyphilis.2The classical text book pictures of tabes dorsalis and general paresis of the insane (GPI) are becoming rare and seem to be replaced by atypical and in-between forms.2 Diagnosis The diagnosis of neurosyphilis is based on clinical judgement. The serologic tests are useful in confirming the diagnosis of syphilis, but nontreponemal serologic tests for syphilis (STS) are not sensitive enough, and can be negative in late stages of