Electroconvulsive treatment of depression associated with neurosyphilis

The authors describe a 67-year-old woman with nontabetic parenchymatous neurosyphilis associated with an affective disorder. It was not possible clinically to distinguish the relative contributions of psychiatric and neurologic etiologies to the patient's depressive and delusional symptoms. ECT proved effective for this patient, who might have otherwise been considered a treatment failure. The authors argue that the signs and symptoms of severe affective disorder should be treated if the presumed physical illness does not respond to therapy.