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Syphilitic myelopathy.

M H Silber1

  • 1Department of Neurology, Groote Schuur Hospital, Cape Town, South Africa.

Genitourinary Medicine
|October 1, 1989
PubMed
Summary
This summary is machine-generated.

Neurosyphilis clinical patterns, specifically syphilitic myelopathy, show no significant change since penicillin

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Neurosyphilis, a tertiary syphilis manifestation, presents diagnostic challenges.
  • The impact of penicillin on neurosyphilis clinical presentation remains debated.
  • Syphilitic myelopathy is a severe form of neurosyphilis affecting the spinal cord.

Purpose of the Study:

  • To evaluate changes in the clinical, laboratory, and radiological features of syphilitic myelopathy.
  • To compare current neurosyphilis patterns with pre-penicillin era observations.
  • To assess the influence of penicillin therapy on disease presentation and prognosis.

Main Methods:

  • Retrospective analysis of nine patients diagnosed with syphilitic myelopathy.
  • Detailed review of clinical presentations, neurological examination findings, and CSF analysis.

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  • Inclusion of radiological findings, such as myelography, to assess disease extent.
  • Comparison of identified patterns with historical data from the pre-penicillin era.

    • Main Results:

    • Four distinct clinical patterns of syphilitic myelopathy were identified.
    • Presentations ranged from subacute paraparesis to slowly progressive weakness.
    • CSF analysis revealed pleocytosis in all patients, with positive VDRL in 77%.
    • Despite treatment, prognosis for neurological recovery was generally poor.

    Conclusions:

    • The clinical presentation of syphilitic myelopathy has not significantly evolved since the introduction of penicillin.
    • Increased clinical suspicion and prompt diagnosis are crucial for timely intervention.
    • Earlier treatment may potentially improve the prognosis for patients with neurosyphilis.