[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.