Reversible neurosyphilis presenting as chronic mania.

A patient is described who was diagnosed in an outpatient department as having paranoid psychosis and later chronic schizophrenia, which was treated with chlorpromazine. Two years later, the patient was admitted to hospital because of increasing confusion, disorganization, and numerous manic symptoms. Physical examination and serologic examination of blood and CSF confirmed the diagnosis of general paresis. Correct treatment led to the eventual discontinuation of neuroleptics and the cessation of paranoid and manic symptoms.