BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuNeurosyphilisSyphilis - neurosyphilisNeurosyphilis is a bacterial infection of the brain or spinal cord. It usually occurs in people who have had untreated syphilis for many years.SyphilisSyphilis is a bacterial infection that is most often spread through sexual contact.ImageRead Article Now Book Mark Article Causes Neurosyphilis is caused by Treponema pallidum bacteria. Neurosyphilis usually occurs about 10 to 20 years after a person is first infected with syphilis. Not everyone who has syphilis develops this complication.There are four different forms of neurosyphilis:Asymptomatic (most common form) AsymptomaticAsymptomatic means there are no symptoms. You are considered asymptomatic if you:Have recovered from an illness or condition and no longer have symp...ImageRead Article Now Book Mark Article General paresis General paresisGeneral paresis is a problem with mental function due to damage to the brain from untreated syphilis.Read Article Now Book Mark Article Meningovascular Tabes dorsalisTabes dorsalisTabes dorsalis is a complication of untreated syphilis that involves muscle weakness and abnormal sensations.ImageRead Article Now Book Mark Article Asymptomatic neurosyphilis occurs before symptomatic syphilis. Asymptomatic means there aren't any symptoms.SymptomaticSymptomatic can mean showing symptoms, or it may concern a specific symptom. Symptoms may be signs of disease or injury. They are what a person fee...ImageRead Article Now Book Mark Article Symptoms Symptoms usually affect the nervous system. Depending on the form of neurosyphilis, symptoms may include any of the following:Abnormal walk (gait), or unable to walk Abnormal walkWalking abnormalities can be caused by many different types of problems. Problems with the joints, (such as arthritis), bones (such as deformities),...ImageRead Article Now Book Mark Article Numbness in the toes, feet, or legs Problems with thinking, such as confusion or poor concentration Mental problems, such as depression or irritability Headache, seizures, or stiff neck SeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Loss of bladder control (incontinence) IncontinenceUrinary (or bladder) incontinence occurs when you are not able to keep urine from leaking out of your urethra. The urethra is the tube that carries ...ImageRead Article Now Book Mark Article Tremors, or weakness Visual problems, even blindnessVisual problemsThere are many types of eye problems and vision disturbances, such as: Halos Blurred vision (the loss of sharpness of vision and the inability to see...ImageRead Article Now Book Mark Article Exams and Tests Your health care provider will do a physical examination and may find the following:Abnormal reflexes Muscle atrophy Muscle atrophyMuscle atrophy is the wasting (thinning) or loss of muscle tissue.ImageRead Article Now Book Mark Article Muscle contractions Mental changes Blood tests can be done to detect substances produced by the bacteria that cause syphilis, this includes: Treponema pallidum particle agglutination assay (TPPA) Venereal disease research laboratory (VDRL) test VDRLThe VDRL test is a screening test for syphilis. It measures substances (proteins), called antibodies, which your body may produce if you have been i...ImageRead Article Now Book Mark Article Fluorescent treponemal antibody absorption (FTA-ABS) FTA-ABSThe FTA-ABS test is used to detect antibodies to the bacteria Treponema pallidum, which causes syphilis.ImageRead Article Now Book Mark Article Rapid plasma reagin (RPR)RPRRPR (rapid plasma reagin) is a screening test for syphilis. It measures substances (proteins) called antibodies that are present in the blood of peo...ImageRead Article Now Book Mark Article With neurosyphilis, it is important to test the spinal fluid for signs of syphilis.Tests to look for problems with the nervous system may include:Cerebral angiogram Cerebral angiogramCerebral angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the brain.ImageRead Article Now Book Mark Article Head CT scan Head CT scanA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article Lumbar puncture (spinal tap) and cerebrospinal fluid (CSF) analysis Lumbar punctureCerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...ImageRead Article Now Book Mark Article Cerebrospinal fluid (CSF) analysisCerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure chemicals in the cerebrospinal fluid. CSF is a clear fluid that surro...ImageRead Article Now Book Mark Article MRI scan of the brain, brainstem, or spinal cord MRIA magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...ImageRead Article Now Book Mark Article Treatment The antibiotic penicillin is used to treat neurosyphilis. It can be given in different ways:Injected into a vein several times a day for 10 to 14 days. By mouth 4 times a day, combined with daily muscle injections, both taken for 10 to 14 days. You must have follow-up blood tests at 3, 6, 12, 24, and 36 months to make sure the infection is gone. You will need follow-up lumbar punctures for CSF analysis every 6 months. If you have HIV/AIDS or another medical condition, your follow-up schedule may be different. Outlook (Prognosis) Neurosyphilis is a life-threatening complication of syphilis. How well you do depends on how severe the neurosyphilis is before treatment. The goal of treatment is to prevent further deterioration. Many of these changes are not reversible. Possible Complications The symptoms can slowly worsen. When to Contact a Medical Professional Contact your provider if you have had syphilis in the past and now have signs of nervous system problems. Prevention Prompt diagnosis and treatment of the original syphilis infection can prevent neurosyphilis.Open ReferencesReferencesEuerle BD. Spinal puncture and cerebrospinal fluid examination. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 60.National Institute of Neurological Disorders and Stroke website. Neurosyphilis. www.ninds.nih.gov/health-information/disorders/neurosyphilis. Updated January 20, 2023. Accessed March 17, 2023.Radolf JD, Tramont EC, Salazar JC. Syphilis (Treponema pallidum). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 237.AllVideoImagesTogCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationLate-stage syphilis - illustration Tertiary syphilis is a late stage of the disease which can follow the initial infection, primary syphilis, by several years. Pockets of damage accumulate in various tissues such as the bones, skin, nervous tissue, heart, and arteries. These lesions are called gummas and are very destructive.Late-stage syphilisillustrationCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationLate-stage syphilis - illustration Tertiary syphilis is a late stage of the disease which can follow the initial infection, primary syphilis, by several years. Pockets of damage accumulate in various tissues such as the bones, skin, nervous tissue, heart, and arteries. These lesions are called gummas and are very destructive.Late-stage syphilisillustrationRelated Information Asymptomatic(Special Topic)Tabes dorsalis(Condition)General paresis(Condition)Symptomatic(Special Topic)Muscle function loss(Symptoms)Seizures(Symptoms)Syphilitic aseptic meningitis(Condition) Review Date: 12/4/2022 Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 03/17/2023. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
NeurosyphilisSyphilis - neurosyphilisNeurosyphilis is a bacterial infection of the brain or spinal cord. It usually occurs in people who have had untreated syphilis for many years.SyphilisSyphilis is a bacterial infection that is most often spread through sexual contact.ImageRead Article Now Book Mark Article Causes Neurosyphilis is caused by Treponema pallidum bacteria. Neurosyphilis usually occurs about 10 to 20 years after a person is first infected with syphilis. Not everyone who has syphilis develops this complication.There are four different forms of neurosyphilis:Asymptomatic (most common form) AsymptomaticAsymptomatic means there are no symptoms. You are considered asymptomatic if you:Have recovered from an illness or condition and no longer have symp...ImageRead Article Now Book Mark Article General paresis General paresisGeneral paresis is a problem with mental function due to damage to the brain from untreated syphilis.Read Article Now Book Mark Article Meningovascular Tabes dorsalisTabes dorsalisTabes dorsalis is a complication of untreated syphilis that involves muscle weakness and abnormal sensations.ImageRead Article Now Book Mark Article Asymptomatic neurosyphilis occurs before symptomatic syphilis. Asymptomatic means there aren't any symptoms.SymptomaticSymptomatic can mean showing symptoms, or it may concern a specific symptom. Symptoms may be signs of disease or injury. They are what a person fee...ImageRead Article Now Book Mark Article Symptoms Symptoms usually affect the nervous system. Depending on the form of neurosyphilis, symptoms may include any of the following:Abnormal walk (gait), or unable to walk Abnormal walkWalking abnormalities can be caused by many different types of problems. Problems with the joints, (such as arthritis), bones (such as deformities),...ImageRead Article Now Book Mark Article Numbness in the toes, feet, or legs Problems with thinking, such as confusion or poor concentration Mental problems, such as depression or irritability Headache, seizures, or stiff neck SeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Loss of bladder control (incontinence) IncontinenceUrinary (or bladder) incontinence occurs when you are not able to keep urine from leaking out of your urethra. The urethra is the tube that carries ...ImageRead Article Now Book Mark Article Tremors, or weakness Visual problems, even blindnessVisual problemsThere are many types of eye problems and vision disturbances, such as: Halos Blurred vision (the loss of sharpness of vision and the inability to see...ImageRead Article Now Book Mark Article Exams and Tests Your health care provider will do a physical examination and may find the following:Abnormal reflexes Muscle atrophy Muscle atrophyMuscle atrophy is the wasting (thinning) or loss of muscle tissue.ImageRead Article Now Book Mark Article Muscle contractions Mental changes Blood tests can be done to detect substances produced by the bacteria that cause syphilis, this includes: Treponema pallidum particle agglutination assay (TPPA) Venereal disease research laboratory (VDRL) test VDRLThe VDRL test is a screening test for syphilis. It measures substances (proteins), called antibodies, which your body may produce if you have been i...ImageRead Article Now Book Mark Article Fluorescent treponemal antibody absorption (FTA-ABS) FTA-ABSThe FTA-ABS test is used to detect antibodies to the bacteria Treponema pallidum, which causes syphilis.ImageRead Article Now Book Mark Article Rapid plasma reagin (RPR)RPRRPR (rapid plasma reagin) is a screening test for syphilis. It measures substances (proteins) called antibodies that are present in the blood of peo...ImageRead Article Now Book Mark Article With neurosyphilis, it is important to test the spinal fluid for signs of syphilis.Tests to look for problems with the nervous system may include:Cerebral angiogram Cerebral angiogramCerebral angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the brain.ImageRead Article Now Book Mark Article Head CT scan Head CT scanA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article Lumbar puncture (spinal tap) and cerebrospinal fluid (CSF) analysis Lumbar punctureCerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...ImageRead Article Now Book Mark Article Cerebrospinal fluid (CSF) analysisCerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure chemicals in the cerebrospinal fluid. CSF is a clear fluid that surro...ImageRead Article Now Book Mark Article MRI scan of the brain, brainstem, or spinal cord MRIA magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...ImageRead Article Now Book Mark Article Treatment The antibiotic penicillin is used to treat neurosyphilis. It can be given in different ways:Injected into a vein several times a day for 10 to 14 days. By mouth 4 times a day, combined with daily muscle injections, both taken for 10 to 14 days. You must have follow-up blood tests at 3, 6, 12, 24, and 36 months to make sure the infection is gone. You will need follow-up lumbar punctures for CSF analysis every 6 months. If you have HIV/AIDS or another medical condition, your follow-up schedule may be different. Outlook (Prognosis) Neurosyphilis is a life-threatening complication of syphilis. How well you do depends on how severe the neurosyphilis is before treatment. The goal of treatment is to prevent further deterioration. Many of these changes are not reversible. Possible Complications The symptoms can slowly worsen. When to Contact a Medical Professional Contact your provider if you have had syphilis in the past and now have signs of nervous system problems. Prevention Prompt diagnosis and treatment of the original syphilis infection can prevent neurosyphilis.Open ReferencesReferencesEuerle BD. Spinal puncture and cerebrospinal fluid examination. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 60.National Institute of Neurological Disorders and Stroke website. Neurosyphilis. www.ninds.nih.gov/health-information/disorders/neurosyphilis. Updated January 20, 2023. Accessed March 17, 2023.Radolf JD, Tramont EC, Salazar JC. Syphilis (Treponema pallidum). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 237.