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Clinical Characteristics of Neurosyphilis

XU Zhi-peng;LI Hong-hua;CHEN Wen-jun;WU Qiang;LIN Lang;Department of Neurology, Wuhan General Hospital of Guangzhou Command;  
Objective:To investigate the clinical characteristics and early diagnostic evidence of neurosyphilis.Methods: Clinical data of 10 cases with neurosyphilis who were hospitalized from May 2010 to January 2013were retrospectively analyzed. Results: The initial symptoms of 10 neurosyphilis patients included dementia(3cases), tabes dosalis(3 cases), cerebral infarction(1 case), meningitis(1 case), Parkinson syndrome(1 case) and epilepsia(1 case). The treponema pallidum particle assay(TPPA) and rapid plasma regain test(RPR) of 10 serum samples were positive. Cerebrospinal fluid(CSF) examination revealed a normal pressure in all the cases.. CSF protein was increased in 9 cases and leukocyte counts(predominantly lymphocytes) were increased in 4 cases.TPPA was positive in 8 CSF samples and RPR in 5. MRI revealed brain atrophy and multiple lesions manifesting T2 high signal intensity and T1 low signal intensity in the brain or spine cord. Most of the patients' symptoms were improved significantly after treatment of syphilis. Conclusion: The diagnosis of neurosyphilis depends on clinical presentation, laboratory and imaging examinations. Early treatment of neurosyphilis can improve the prognosis.
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