Neurosyphilis is a great ‘mimicker’ and can present with a wide array of signs and symptoms. Taking a detailed history in susceptible individuals is paramount. [ncbi.nlm.nih.gov]

Acute syphilitic transverse myelitis: unusual presentation of meningovascular syphilis. Abstract A case of meningovascular syphilis presenting with the rare spinal cord manifestations is reported. [sti.bmj.com]

We adopted strict diagnostic criteria of NS in the present investigation. [cureus.com]

Abstract The radiologic findings in three cases of meningovascular syphilis are presented. [pubs.rsna.org]

As with the clinical features, neurosyphilis can have a variety of radiographic presentations 1-3. [radiopaedia.org]

• Vomiting

  headache. 03:55 And sometimes the vomiting is projectile, sort of effortless vomiting. 04:02 That's a sign of increased intracranial pressure. 04:06 Or they may have acute hydrocephalus without any focal signs. 04:11 And some patients may have meningitis [lecturio.com]

  Along with this, there are bladder disorders, erectile dysfunction and delayed ejaculation in men, acute abdominal pain and vomiting (visceral crises). [minclinic.ru]

  DISCUSSION Symptomatic meningitis may occur years later, with headache and neck pain, confusion, nausea, vomiting, stiffness, seizures, decreased visual acuity, cranial neuropathies, cerebral arteritis, syphilitic leptomeningitis or gums causing back [revistanefrologia.com]

  CMAJ June 05, 2007 176 (12) 1699-1700; DOI: https://doi.org/10.1503/cmaj.070371 © 2007 Canadian Medical Association Case 1: A previously healthy 51-year-old man came to hospital complaining of headache of 3 weeks' duration and several days of nausea, vomiting [cmaj.ca]

  He had previous flu-like syndrome with abdominal pain, vomiting and diarrhea for three days. The present symptoms started with slight weakness of bilateral legs after he was awake. [file.scirp.org]

• Nausea

  […] of syphilitic meningitis. 03:35 About 50% or more recall having had a chancre or some kind of rash that was consistent with secondary syphilis, or they may have had both. 03:47 The classic findings are signs of increased intracranial pressure such as nausea [lecturio.com]

  DISCUSSION Symptomatic meningitis may occur years later, with headache and neck pain, confusion, nausea, vomiting, stiffness, seizures, decreased visual acuity, cranial neuropathies, cerebral arteritis, syphilitic leptomeningitis or gums causing back [revistanefrologia.com]

  Jeerakathil CMAJ June 05, 2007 176 (12) 1699-1700; DOI: https://doi.org/10.1503/cmaj.070371 © 2007 Canadian Medical Association Case 1: A previously healthy 51-year-old man came to hospital complaining of headache of 3 weeks' duration and several days of nausea [cmaj.ca]

  Symptoms include: nausea vomiting a stiff neck a headache It may also cause a loss of hearing or vision. Meningovascular neurosyphilis This is a more serious form of meningeal neurosyphilis. In this case, you would also have had at least one stroke. [healthline.com]

  […] like; heart attack, obstruction to blood flow (ischemia, occlusion), and blood clot formations General Paresis of the Insane Tabes Dorsalis Optic Atrophy Tertiary Syphilis: Neurosyphilis – Meningovascular signs and symptoms include: Stroke Vomiting and nausea [dovemed.com]

• Diplopia

  The spectrum of neurological manifestations includes aphasia, hemiparesis, hemianesthesia, meningoradicular irritation (headache and vomiting), diplopia, vertigo, dysarthria, various diffuse encephalic symptoms (apathy, vertigo, and bad attention), and [cureus.com]

  Luxon et al describe patients presenting with diplopia due to sixth nerve palsy, deterioration of vision due to optic neuritis, primary optic atrophy or choroidoretinitis, and otological symptoms such as sudden deafness or repeated vertigo. [kraeplinpsychiatry.wordpress.com]

• Neuropathic Arthropathy

  Total knee arthroplasty in neuropathic arthropathy. J Bone Joint Surg Br. 2002 Mar. 84(2):216-9. [QxMD MEDLINE Link]. Marra CM, Maxwell CL, Tantalo LC, Sahi SK, Lukehart SA. [emedicine.medscape.com]

• Headache

  It may include persistent headaches, personality disturbances, emotional liability, vertigo, and insomnia [24]. [cureus.com]

  Headaches and vasculitis; Tonsilar ectopia and headaches; Post-traumatic headaches; Metabolic headaches; Temporomandibular joint disorders, bruxism, and headaches. [books.google.com]

  The combination of prominent and persistent headaches and stroke may suggest meningovascular syphilis even in the absence of meningism. [cmaj.ca]

  The infection has symptom headache, has symptom neck stiffness, has symptom dizziness, has symptom behavioral abnormalities, has symptom poor concentration, has symptom memory loss, has symptom lassitude, has symptom insomnia, has symptom blurred vision [malacards.org]

  Our patient did not have headache, jaw claudication or visual symptoms of giant cell arteritis (GCA). Blindness and stroke can occur in GCA which affects people over 50 years. [ncbi.nlm.nih.gov]

• Personality Change

  The prodromal clinical course of several months to years before a focal neurologic deficit has been described in 10 patients (71%), such as persistent headaches (70%), and personality changes (60%). [cureus.com]

  When there is focal inflammation the clinical picture is characterized by hemiplegia, whereas in the case of multifocal involvement of small intracranial arteries, it presents with a slowly progressive loss of cognitive functioning and personality changes [karger.com]

  Prognosis is generally good unless there are established non-reversible changes such as cerebral infarction or atrophy 1,10 . [radiopaedia.org]

  If it develops, general paresis may lead to several health problems, including: paranoia mood swings emotional troubles personality changes weakened muscles a loss of the ability to utilize language It can also progress to dementia. [healthline.com]

• Dizziness

  His chief complaints were double vision and dizziness, with mild exodeviation in both eyes in primary gaze position in the ocular motility examination, but more predominant in the left eye. [pesquisa.bvsalud.org]

  The infection has symptom headache, has symptom neck stiffness, has symptom dizziness, has symptom behavioral abnormalities, has symptom poor concentration, has symptom memory loss, has symptom lassitude, has symptom insomnia, has symptom blurred vision [malacards.org]

  However, about 50% of patients have premonitory symptoms of headache, dizziness, insomnia, memory loss, or mood disturbances lasting for weeks or months, probably consistent with diffuse arterial involvement. [std-aid.com]

• Dysarthria

  Neurologic examination revealed severe dysarthria, dysphagia, and quadriplegia (left upper limb 4/5, left lower limb 3/5, right upper limb 2/5 and right lower limb 2/5). [neurologyindia.com]

  General paresis is characterized by progressive DEMENTIA; DYSARTHRIA; TREMOR; MYOCLONUS; SEIZURES; and Argyll-Robertson pupils. [fpnotebook.com]

  Later, by afternoon there were progressive neurological symptoms such as dysarthria and clumsiness of both hands. Within hours, his level of consciousness worsened progressively, and he became quadriparetic. [file.scirp.org]

  Left-sided hemiplegia and facial palsy with minor dysarthria Mitral and aortic valve insufficiency Unremarkable Iritis and vitritis Normal 23 7 40 M Yes Unremarkable Persistent headaches Two years Sudden-onset of short-term confusional state Confusional [cureus.com]

• Cranial Nerve Involvement

  Cranial nerve involvement can result in hearing loss, facial weakness, or visual disturbances. Syphilis can also affect the spinal cord, causing meningomyelitis. [health.am]

  The clinical syndromes included focal neurological manifestations such as cranial nerve involvement and including range of manifestations including meningitis, meningovascular syphilis, tabes dorsalis and dementia ( Table 1 ). [journals.plos.org]

  Cranial neuropathies are common. The cranial nerves affected are, in descending order of frequency, cranial nerves VII, VIII, VI, and II. [emedicine.medscape.com]

Nontreponemal syphilis screening tests such as the rapid plasmin reagin test should be reincorporated into the diagnostic workup of any young patient with stroke and all patients with stroke who have the historical or clinical features outlined. [cmaj.ca]

[…] reliable, inferior altitudinal defect, enlargement of the blind spot OS: reliable, normal Laboratory testing September 2016 RPR 1:2 FTA ABS + CSF 5 cells, protein 30, Glucose 191 (serum 298) CSF VDRL negative HIV negative Additional infectious/inflammatory workup [eyewiki.aao.org]

Because the face of syphilis within the dominion of neurology has changed tremendously over the years and as screening tests for syphilis are increasingly becoming routine components of acute stroke laboratory workup (especially in younger patients), [practicalneurology.com]

Neurosyphilis is a treatable cause of dementia and movement disorders, and the disorder must be considered as a possible diagnosis in the routine workup of patients with cognitive decline and movement disorders. [bmcresnotes.biomedcentral.com]

Muscle weakness Upon further diagnostic workup, the following signs may be present: Abnormal reflexes Muscle atrophy Muscle contractions Approximately 35% to 40% of persons with secondary syphilis have asymptomatic central nervous system (CNS) involvement [psychology.wikia.com]

• Cerebrospinal Fluid Abnormality

  Fluid and Clinical Abnormalities after Treatment of Neurosyphilis M. [studyres.com]

  Interesting correlations were found in relation to the cerebrospinal fluid abnormalities at the time of treatment. [kraeplinpsychiatry.wordpress.com]

  There are no established guidelines for the appropriate rate of resolution of cerebrospinal fluid abnormalities in patients with neurosyphilis. [nejm.org]

  Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features. J Infect Dis. 2004 Feb 1. 189(3):369-76. [QxMD MEDLINE Link]. Holmes MD, Brant-Zawadzki MM, Simon RP. [emedicine.medscape.com]

• Periodic Lateralized Epileptiform Discharges

  Pohlmann-Eden B, Hoch DB, Cochius JI, Chiappa KH: Periodic lateralized epileptiform discharges-a critical review. [cureus.com]

  Periodic lateralized epileptiform discharges in neurosyphilis. Epilepsia. 2007 Feb. 48(2):390-3. [QxMD MEDLINE Link]. Chang CC, Leslie DE, Spelman D, Chua K, Fairley CK, Street A. [emedicine.medscape.com]

• Hyperviscosity

  Cryoglobulinaemia-associated vasculitis can be associated with multiorgan involvement, lymphoproliferative disorders, hepatitis C infection, hyperviscosity and cerebral infarction. [ncbi.nlm.nih.gov]

Most commonly, CSF-VDRL is used as CSF FTA-Abs is very expensive.5 Management The management of MVS includes antibiotic treatment as for neurovascular syphilis and stroke-specific treatment. [ncbi.nlm.nih.gov]

The treatment of syphilis has been proved controversial, and the best practice for management continues to be debated [42]. Penicillin remains the drug of choice for the treatment of syphilis. The CDC recommended two different regimens. [cureus.com]

After seven-days of low molecular weight heparin (LMWH) treatment, the patient improved dramatically with NIHSS score of 2 before being transferred to HIV center for further treatment. [file.scirp.org]

The rapid identification of the pathology contributed to the better prognosis of the patient [pesquisa.bvsalud.org]

The rapid identification of the pathology contributed to the better prognosis of the patient. [elsevier.es]

Prognosis is generally good unless there are established non-reversible changes such as cerebral infarction or atrophy 1,10 . [radiopaedia.org]

Although the radiologic findings are nonspecific, the diagnosis of meningovascular syphilis should be considered in patients with vasculitis of uncertain etiology. Article History Published in print: 1986 [pubs.rsna.org]

Although the radiologic findings are nonspecific, the diagnosis of meningovascular syphilis should be considered in patients with vasculitis of uncertain etiology. [ncbi.nlm.nih.gov]

The secondary headaches include a diverse and fascinating array of etiologies which can mimic primary headache disorders ranging from the rare to the mundane and from the well established to the highly controversial. [books.google.com]

Etiology Treponema bacteria (particularly during stages I/II) are highly contagious! Sexual contact with a partner who suffers from active syphilis will lead to infection in 30% of cases! [amboss.com]

Epidemiology References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. Etiology Treponema bacteria (particularly during stages I/II) are highly contagious! [amboss.com]

It thus requires further studies of the epidemiology and treatment of these STD co-infected young meningovascular disease. [file.scirp.org]

Epidemiology Treponema pallidum, the causative agent of syphilis, belongs to the family Spirochaetaceae and is a unicellular, spiral organism that cannot be cultivated in vitro. [pedsinreview.aappublications.org]

Epidemiology, treatment and molecular typing of Treponema pallidum. Dan Med J. 2015 Dec;62(12):B [emdocs.net]

Our data suggest that neuosyphilis remains an important disease in Africa but better prospective studies are needed to understand its epidemiology. [journals.plos.org]

Get a quick and memorable overview of anatomy, pathophysiology, and clinical presentation from the precision and beauty of Netter and Netter-style plates that highlight key neuroanatomical and neurologic concepts. [books.google.com]

A review of demographic and clinical features, neuroimaging findings, cerebrospinal fluid changes, treatment and outcome, pathophysiology mechanism of meningovascular syphilis are presented. [cureus.com]

References: [3] [4] Pathophysiology Clinical features Primary syphilis Primary lesion ( chancre ) Typically starts out as a solitary, raised papule (usually on the genitals) Evolves into painle ss, firm ulcer with indurated borde rs and smooth base Resolves [amboss.com]

(serum 298) CSF VDRL negative HIV negative Additional infectious/inflammatory workup negative History In 2011 the patient had tested positive for a “venereal disease” and was treated with 2-3 intramuscular injections Ocular syphilis (Neurosyphilis) Pathophysiology [eyewiki.aao.org]

Pathophysiology The disease syphilis was reported in the medical literature as early as 1495. In the treatment of syphilis. heavy metals, such as arsenic, were replaced by penicillin 1940. [labpedia.net]

[…] of HIV HIV Transmission and Prevention in Specific Populations Systematic Review of HIV Behavioral Prevention Research in African Americans Lynae A. [hivinsite.ucsf.edu]

Chapter 69 Surrogate Markers of Antiretroviral Efficacy 826 Overcoming Barriers to Providing ARV Therapy in ResourceLimited Settings 831 Chapter 71 Antiretroviral Drugs for HIV Prevention 836 Chapter 72 Acute HIV Infection 843 Chapter 73 Opportunistic [books.google.com]

They have to be also aware of the preventive measures and precautions to be taken, which include: Avoidance of multiple sex partners Practice of safe sex (use of condoms that prevent entry of the syphilis bacteria) Excessive craving for drugs and alcohol [dovemed.com]

The conclusion is that NS is a disease that still prevails and that appropriate diagnosis and treatment prevent irreversible neurological sequelae. Biblioteca responsável: CL1.1 [pesquisa.bvsalud.org]

Under this law there are chapters on prevention and control. [microbewiki.kenyon.edu]