What is Neurosyphilis?

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  • Written By: N. Madison
  • Edited By: Bronwyn Harris
  • Last Modified Date: 25 September 2019
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Neurosyphilis is a very serious infection that affects the brain and can also affect the spinal cord. It develops when a person has syphilis that isn't treated for years after the initial infection. In fact, a person may have syphilis for 10 to 20 years before neurosyphilis develops. The condition is life threatening, but it does not affect everyone who is diagnosed with syphilis.

There are four types of neurosyphilis: asymptomatic, meningovascular, tabes dorsalis, and general paresis. With the asymptomatic type, there are no recognizable symptoms. The affected person will have signs of the disease in his spinal fluid, however. The meningovascular form does cause symptoms, which include nerve and eye problems. Also, a person with this condition may have an increased risk of stroke, as the blood vessels may be damaged.

A person with tabes dorsalis neurosyphilis has damage to the spinal cord, which gradually worsens. Eventually, the affected person will lose her ability to walk. General paresis is marked by damage to the brain cells, which may cause paralysis as well as seizures and a deteriorating mental state. With this condition, parts of the brain and spinal cord may become inflamed, causing a wide range of neurological issues.


Besides paralysis and seizures, general paresis can cause tremors, headaches, mood and personality changes, muscle weakness, and strokes. It may also lead to vision problems, vertigo, depression, incontinence, and dementia. A person with this type of neurosyphilis may have abnormal muscle contractions and even muscle atrophy.

Blood tests are used to diagnose syphilis. These tests look for substances that are created by the bacteria that cause the disease. For neurosyphilis, however, the patient's spinal fluid must be tested. Additionally, lumbar punctures, CT scans, MRIs, and cerebral angiograms are used to detect problems that affect the nervous system.

Treatment typically involves penicillin, an antibiotic. For one treatment plan, the patient receives penicillin injections into a vein for the first 10 days. After that, another form of the antibiotic may be injected into the muscle for another three-week period. Another treatment plan involves taking the antibiotic orally four times each day while simultaneously submitting to injections into a muscle for a total of 10 days. After that, another form of the antibiotic would be injected into a muscle for a total of three weeks.

Recovery from neurosyphilis depends on how soon it is discovered and how severe it is when treatment starts. Follow-up tests are necessary at three, six, 12, and 24 months after treatment. These tests are necessary to make sure the disease is truly gone. When left untreated, neurosyphilis can lead to death.


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