What is Neurosyphilis?

While completing her Ph.D., Angela, 27, fell deeply in love with the man she considered her soul mate. She was devastated when Greg dropped out of his graduate program and left the campus without telling anyone his destination. In Chicago's O'Hare Airport four years later, she was stunned to run into his parents. They initially acted distant. Gregg's mother finally asked Angela why she hadn't come to his funeral. At that moment, Angela began a bizarre medical odyssey, ultimately discovering that her soul mate had suffered from syphilis and that her recurrent headaches and visual disturbances were linked to neurosyphilis.

What is Neurosyphilis?

According to the National Institute of Neurological Disorders and Stroke (NINDS), this disease affects the coverings of the human brain, the spinal cord or the brain itself.

Neurospyhilis is considered an infection. MedlinePlus indicates that its cause is the bacteria Treponema pallidum. This is the bacteria responsible for syphilis.

The disease typically strikes individuals with syphilis that's been untreated for years. While not every patient with syphilis develops neurosyphilis, in those who do, the illness can appear decades after infection.

Signs and Symptoms

Some patients with neurosyphilis have no symptoms. Among the most common signs of the disease are headaches, blindness or visual disturbances, an abnormal gait, confusion or even dementia, depression and a generalized weakness.

Other common symptoms are incontinence, difficulty walking, numbness in the extremities, inability to concentrate and seizures. Some individuals suffer from stiff necks and tremors.

Types of Neurosyphilis

Doctors divide this disease into five types. The particular type a patient has greatly determines the prognosis.

Asymptomatic. This is the most common form and is sometimes present before the patient notices any symptoms. The individual simply doesn't feel sick and therefore receives no treatment unless the condition is discovered accidentally.

General paresis. This type is now considered rare. It typically appears between 15 to 20 years after the initial syphilis infection, though intervals as wide as 3 to 30 years occur. Cognitive and behavioral changes are common. Without treatment, patients become disabled and face an increased likelihood of contracting other infections and diseases.

Meningeal. This form of neurosyphilis most often develops within a few years after an individual contracts syphilis. It can appear as early as a few weeks after infection. In addition to headaches and a stiff neck, a patient is likely to experience nausea and vomiting. Some suffer vision or hearing loss.

Meningovascular. In addition to the signs of the meningeal type, this form causes patients to suffer strokes. It usually occurs within a few months to several years after infection with syphilis.

Tabes dorsalis. Patients seldom develop this type of the disease until at least five years following a syphilis infection. However, it might develop as many as 50 years after infection. This is also considered a rare form of neurosyphilis, It results in muscle weakness and abnormal sensations due to damage to the spinal cord and peripheral nerve tissue.

Diagnosis and Treatment

Doctors detect the presence of neurosyphilis from a physical exam in which they look for abnormal reflexes, muscle contractions and muscle atrophy. They also order blood tests that look for certain byproducts of the bacteria that cause syphilis. The measurement that's been around the longest is the VDRL test, although there are now several others.

Most doctors order an analysis of spinal fluid for patients who have symptoms. Other tests include a cerebral angiogram; an MRI scan of the brain, brainstem and/or spinal cord; and a CT scan of the head.

The standard treatment for neurosyphilis is pencillin, which can be administered in different ways. Patients receive injections several times a day into a vein for up to two weeks or take an oral medication four times a day. Oral medications must be combined with daily muscle injections over a period of 10 to 14 days.

The prognosis for a patient with neurosyphilis depends on the severity of the illness before treatment. However, the disease is considered a life-threatening condition.

Sources:

http://www.ninds.nih.gov/disorders/neurosyphilis/neurosyphilis.htm

http://www.nlm.nih.gov/medlineplus/ency/article/000703.htm