[Neurosyphilis]

Neurosyphilis is a central nervous system infection caused by Treponema pallidum and can occur at any stage of syphilis, presenting with diverse neurological and psychiatric manifestations. Although once considered a disease of the past, the recent global resurgence of syphilis has renewed the clinical relevance of neurosyphilis. Early manifestations include meningitis, cranial neuropathies, and meningovascular disease, whereas late-stage disease is characterized by parenchymal involvement, such as general paresis and tabes dorsalis. Diagnosis requires clinical suspicion and is based on combined serological testing and cerebrospinal fluid analysis. Neuroimaging may provide supportive information depending on the disease subtype. Intravenous high-dose penicillin G remains the standard treatment, and early therapeutic intervention is essential to prevent irreversible neurological damage. This review summarizes the current understanding of the clinical features, diagnostic approaches, differential diagnoses, and treatment strategies of neurosyphilis, highlighting the importance of timely recognition in contemporary neurological practice.