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Definition Return to top
Neurosyphilis is an infection of the brain or spinal cord. It occurs in persons with untreated syphilis many years after they are first infected.
Causes Return to top
Neurosyphilis is caused by Treponema pallidum, the bacteria that cause syphillis. It occurs about 10 - 20 years after a person is first infected with syphilis. Not everyone who has syphilis will develop this complication.
There are four different forms of neurosyphilis:
Asymptomatic neurosyphilis occurs before symptomatic syphilis.
Symptoms Return to top
Note: There may be no symptoms
Exams and Tests Return to top
Blood tests can be done to detect substances produced by the bacteria that cause syphilis. The oldest test is the VDRL test.
Other tests include:
In neurosyphilis, it is important to test the spinal fluid for signs of syphilis.
Tests to look for problems with the nervous system may include:
Treatment Return to top
Penicillin is used to treat neurosyphilis. The medicine may be given in various ways.
You must have follow-up blood tests and lumbar punctures for CSF fluid analysis at 3, 6, 12, and 24 months to make sure the infection is gone.
For information on treating syphilis, see the following articles:
Outlook (Prognosis) Return to top
This is considered a life-threatening complication of syphilis. How well you do depends on how severe the neurosyphilis is before treatment.
Possible Complications Return to top
The symptoms can get slowly worse.
When to Contact a Medical Professional Return to top
Call for an appointment with your health care provider if you have had syphilis in the past and now have signs of neurological problems.
Prevention Return to top
Prompt diagnosis and treatment of the original syphilis infection can prevent neurosyphilis.
References Return to top
Hook EW. Syphilis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 340.
Tramont EC. Treponema pallidum (syphilis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2005: chap 235.
Screening for syphilis infection: Recommendation statement. Rockville MD, US Preventive Services Task Force: July 2008.Update Date: 9/28/2008 Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, PhD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.