[Biological, psychometric and tomodensitometric study of treated neurosyphilis]

Results of follow-up examinations of the CSF in 6 patients with neurosyphilis, including 5 with general paresis, following treatment with high doses of aqueous penicillin G are reported. Persistence of any residual active infection of the nervous system could be eliminated since as well as fairly rapid restoration of normal CSF cytology and chemistry there was a slow reduction (and sometimes return to normal) of initially very high levels of immunoglobulins G, disappearance of their oligoclonal distribution (3 cases), and negativation of quantitative immunofluorescence serology (F.T.A. ABS). Clinical efficacy of treatment was shown by stabilization of the intellectual deficit investigated by serial psychometric tests. Memory disturbances were prominent mainly in the initial stages, and sometimes adopted a rather frontal nature. Psychometric tests can contribute to the assessment of initial extension of the treponemic infection in the aborted types of general paresis. The atrophy observed constantly on CT scans appeared to be stationary on serial examinations (2 cases). It was of a diffuse type affecting cortical sulci and ventricles. The onset of anomalies such as ischemic complications was not related to recurrence of infection.