[Dementia caused by neurosyphilis: clinical and neuropsychological follow-up of a patient].
Dementia is one of the manifestations of late syphilis and it is characterized by cognitive deterioration and behaviour disturbances. We report on a male patient with cognitive decline, behaviour disorder, hyperactivity, hallucinations, short-term memory and Argyll Robertson pupils due to neurosyphilis. Minimental state test (MST) was 16. Cerebrospinal fluid (CSF) protein concentration was 82 mg/dl, CSF-leucocyte count 128 cells/mm3 (98% mononuclear cells), CSF-VDRL 1:4, and CSF-T.pallidum haemaglutination assay 1:2560. MRI showed no cerebral alteration, but SPECT revealed left fronto-temporal hypocaptation. He received intravenous penicillin. MST done 3 months after the treatment scored 22. A new spinal tap showed normal CSF. Neurosyphilis should be part of the differential diagnosis of every patient showing cognitive deterioration and behaviour disturbances. During follow-up, MMS is an useful instrument to ++measure cognitive decline and response to treatment.
Serviço de Neurologia, Hospital do Aparelho Locomotor - SARAH, Brasília, DF, 70334-900, Brasil.
A P
AP
Vargas
F J
FJ
Carod-Artal
M C
MC
Del Negro
M P
MP
Rodrigues
D001519:Behavior; D001921:Brain / Q000000981:diagnostic imaging; D003071:Cognition; D003704:Dementia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D010406:Penicillins / Q000627:therapeutic use; D015899:Tomography, Emission-Computed, Single-Photon
D010406:Penicillins