Neurosyphilis

Definition

Neurosyphilis is an infection of the brain or spinal cord. It occurs in persons with untreated syphilis many years after they are first infected.

Causes

Neurosyphilis occurs about 10 to 20 years after first being infected with syphilis. It is considered a life-threatening complication of syphilis. Not everyone who has syphilis will develop this complication.

There are four different forms of neurosyphilis:

• Asymptomatic
• Meningovascular
• Tabes dorsalis
• General paresis

Asymptomatic neurosyphilis occurs before symptomatic syphilis. Signs of the disease may be seen in the spinal fluid, but the person has no symptoms.

Meningovascular neurosyphilis causes nerve and eye problems, among other symptoms. There may be damage to the blood vessels, which can lead to a stroke.

Persons with tabes dorsalis have damage to the spinal cord that slowly gets worse, making them unable to walk.

In general paresis, brain cell damage causes paralysis, tremors, seizures, and mental decline. Inflammation may occur anywhere in the brain or spinal cord and can lead to a number of neurological problems.

References

Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. London: Churchill Livingstone; 2005:2274-2276.

U.S. Preventive Services Task Force. Screening for Syphilis Infection: Recommendation Statement. Ann Fam Med 2004; 2: 362-365.