Related Experiment Video
Updated: May 12, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Neurosyphillis presenting with normal pressure hydrocephalus in a 76 year old man
Shaffer R S Mok1, Vivek Punjabi, David L Shklar
1Department of Internal Medicine, Division of Internal Medicine, Cooper University Hospital, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School-Camden, Camden, NJ, U.S.A.
Background:
Normal pressure hydrocephalus (NPH) is composed of gait abnormalities, urinary incontinence and decline in mentation. It is uncommonly induced by syphilitic infection.
Case Report:
A 76 year-old male present with gait disturbances, urinary incontinence, declining vision and cognition, with a known diagnosis of NPH. He underwent therapeutic lumbar puncture (LP), which demonstrated leukocytosis and elevated protein. Venereal disease research laboratory testing (VDRL) was reactive in a 1:64 dilution with positive fluorescent Treponemal Antibody (FTA-Abs). The subject was treated with 14 days of Intravenous (IV) Penicillin 3 million units for 3 weeks and intramuscular benzathine PCN for 2 shots, with marked clinical improvement.
Conclusions:
The incidence of Tabes Dorsalis is limited in the age of penicillin, especially in subjects without HIV. Subjects are diagnosed with either LP RPR or VDRL, confirmed with FTA-Abs. Common treatment is IV PCN 1.4-3 mU for 10-14 days.
Related Concept Videos
Brain Abscess l: Introduction
Increased Intracranial Pressure ll: Pathophysiology
Bacterial Meningitis I: Introduction
Increased Intracranial Pressure l: Introduction
Bacterial Meningitis II: Pathophysiology
Encephalitis l: Introduction
