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[A case of successful antisyphilitic treatment for a patient with general paresis]

H Hirasawa1, O Asakawa, K Koyama

  • 1Department of Psychiatry, Tokyo Metropolitan Geriatric Hospital.

Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
|October 1, 1994
PubMed

Insights

Early penicillin treatment of general paresis in a 59-year-old male significantly improved cognitive function and cerebrospinal fluid (CSF) abnormalities. This highlights the crucial role of timely diagnosis and intervention for neurosyphilis.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Neurology

Background:

  • General paresis, a late stage of neurosyphilis, can cause severe cognitive and psychiatric symptoms.
  • Early diagnosis and treatment are critical for managing neurosyphilis and preventing irreversible neurological damage.

Observation:

  • A 59-year-old male presented with personality changes and memory deficits, indicative of general paresis.
  • Cerebrospinal fluid (CSF) analysis revealed elevated white blood cell count, protein, and positive FTA-ABS, with high TPHA titers in serum and CSF.
  • Cognitive assessment showed a low Mini Mental State score (11) and IQ (56).

Findings:

  • Treatment with intramuscular and intravenous penicillin resulted in significant improvement in CSF abnormalities, mood, and agitation.
  • The patient's Mini Mental State score increased to 17, and his IQ improved to 74.
  • Functional and social capabilities were restored post-treatment.

Implications:

  • This case underscores the importance of early detection and prompt treatment of general paresis to reverse cognitive decline and improve patient outcomes.
  • Effective penicillin therapy can lead to substantial recovery in patients with neurosyphilis.
  • Highlights the need for vigilance in diagnosing syphilis-related neurological complications.

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