[The clinical diagnosis and therapy of neurosyphilis].
OBJECTIVE
To study the clinical features, neuroimages, laboratory findings, therapy and prognosis of neurosyphilis.


METHODS
The clinical features, neuroimages, laboratory findings and therapy of 18 patients with neurosyphilis were analyzed retrospectively.


RESULTS
Interstitial neurosyphilis especially meningovascular syphilis was the most common type of which the clinical features varied widely. Treponema pallidum hemagglutination assay (TPHA) test of both serum and CSF samples might be positive, but the positive rate in CSF was lower than that in serum. MRI of syphilitic gumma was typical. Penicillin is the drug of first choice for effective treatment except syphilitic gumma, which should be treated with resectopn. The effective rate of penicillin is 93%.


CONCLUSIONS
Patients with neurosyphilis may present diverse clinical symptoms at the beginning of the course, therefore it is misdiagnosed easily at the first visit. It is important to comprehend that positive syphilis antibody test in serum or CSF is specific for the diagnosis. Penicillin is the drug of first choice for effective treatment.
Yang
Xiao-Su
XS
Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhang
Li-Fang
LF
Xiao
Bo
B
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood / Q000134:cerebrospinal fluid; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D010406:Penicillins / Q000627:therapeutic use; D012189:Retrospective Studies; D014210:Treponema pallidum / Q000187:drug effects / Q000276:immunology
D000907:Antibodies, Bacterial; D010406:Penicillins