Neurosyphilis: Symptoms and Treatment


Neurosyphilis is a venereal disease that disrupts the performance of some internal organs, and in case of untimely treatment, for a short period of time, it can spread to the nervous system. Often occurs at any stage of syphilis. Progression of neurosyphilis is manifested by symptoms such as attacks of severe dizziness, muscle weakness, the onset of seizures, often paralysis of limbs and dementia.

The main way of infection is sexual, after which the infectious process spreads along the body along with the blood flow. The organism of the infected person produces antibodies, but with the development of the pathological process, their quantity decreases, after which the virus penetrates into the central nervous system. Despite this, the disease may not only be acquired. Also there is a congenital disorder, in which intrauterine infection of the fetus is observed. Diagnosis is based on a symptomatic manifestation of the disease, examinations of a neurologist and oculist, a hardware examination using MRI and CT of the brain, as well as the results of a blood test for syphilis. Elimination of the disease is carried out by introducing into the human body drugs with a high content of penicillin.

Etiology

Since the main factor in the onset of an ailment is a bacterium, this means that the infection is carried out directly from the infected person. Thus, the main causes of the onset of the disease are:


  • Sexual intercourse is the most common way of transmitting a disease. The virus penetrates through the mucosa or small lesions on the skin. Contraceptives reduce the degree of infection, but do not completely exclude it;
  • blood transfusions;
  • various surgical interventions, in particular for dentists
  • the household way of transmission — is observed only with close contact with the patient. Often, infection occurs through the use of single cutlery or bath accessories
  • intrauterine infection — transmission of a disease directly from mother to fetus

In addition, there are several predisposing factors in the progression of the disease:


  1. wrong tactics or untimely treatment of syphilis
  2. A strong emotional outburst or frequent stress;
  3. decreased immunity due to viral or inflammatory diseases
  4. a wide range of brain injuries;
  5. Mental overexertion
  6. Occupational activity — the risk zone is made up of medical workers who are constantly in contact with various human biological isolates, including blood, sperm or saliva. In these cases, infection can occur with various surgical operations, autopsy or labor.

A characteristic feature is that the most infectious people are those who tolerate the disease in the early stages, in particular in the first two years of the progression of the disease. In later stages, lasting more than five years, patients are less threatened.

Species

In medicine, neurosyphilis is usually divided according to the time of infection. Allocate:


  • Early neurosyphilis is a disease that develops during the first five years after infection with a major disease. Nerve fibers and blood vessels are affected;
  • Late neurosyphilis — from infection to the development of the disease takes more than five years. Nerve cells are involved in the pathological process;
  • congenital neurosyphilis — characteristic signs are expressed during the first year of life of the baby.

In addition, this disease has a characteristic that depends on the degree of expression of symptoms, and can be:


  1. latent — very often diagnosis is carried out randomly, with a planned examination or the establishment of another diagnosis. At the same time, there is no special evidence of an ailment, but a virus is detected through the investigation of the cerebrospinal fluid
  2. syphilitic meningitis — often observed in young people. The main symptoms are weakness of the body and nausea, there is often a slight decrease in visual acuity
  3. dorsal dry — the injuries of the roots and cord of the spinal cord are detected
  4. meningovascular syphilis — in which the circulation of blood in the brain is disturbed. There are problems with sleeping and memory impairment;
  5. gummous neurosyphilis — is characterized by a progressive paralysis. This form is inherent in this type of disease, such as late neurosyphilis.

In any case, if you do not consult a specialist in time for diagnosis and treatment, the disease can lead to disability, complete paralysis or death.

Symptoms

As mentioned above, for each of the forms of the disease there are specific signs. Early neurosyphilis has symptoms such as:


  • Attacks of nausea that often end in vomiting
  • severe headache and dizziness;
  • reduced hearing and visual acuity
  • forgetfulness
  • muscle weakness;
  • Decreased concentration and memory
  • sleep disorders — occur against a background of nocturnal cramps
  • epileptic seizures
  • reduced sensitivity of the pelvic organs

Late neurosyphilis is accompanied by the following symptoms:


  1. complete loss of vision. At first, only one eye is affected, but as the progression progresses blindness will be two-sided;
  2. increased irritability
  3. changing the handwriting and gait of a sick person
  4. increase in body temperature (which does not disturb the patient at an early stage of the disease)
  5. Language tremor
  6. Inadequate behavior
  7. the occurrence of hallucinations.

With time, paralysis, seizures and impaired pelvic function are formed.





Symptoms of a neurosyphilis of an innate character:


  • inflammatory processes of the cornea of ​​both eyes
  • loss of hearing, from a minor degree to its complete absence;
  • deformation of the dentition.

With proper diagnosis and therapy of a congenital ailment, it is possible to stop the progression of the infection, but disorders from the nervous system will remain for life.

Diagnostics

To confirm the correct diagnosis, the expert pushes away from several main criteria — the clinical picture, a positive result of the analysis for syphilis and a laboratory study of cerebrospinal fluid. Important information is neurological examination and additional examination by the oculist patient. In the diagnosis, laboratory blood tests — RIF and RIBT — play an important role. If necessary, they can be performed many times.

In addition, when the latent stage of neurosyphilis is used to study cerebrospinal fluid — for this disease, an increased level of protein is found. Hardware examinations in the form of CT or MRI of the brain or spinal cord are aimed at detecting pathological changes in the envelopes of these organs, the localization of the pathogenic process. An important part of the diagnosis is the differentiation of neurosyphilis from other diseases that have a similar symptomatology. Such ailments include — vasculitis, meningitis of various nature, sarcoidosis, malignant neoplasms in the spinal cord or brain.

Treatment

Neurosyphilis treatment is carried out only in a hospital setting by introducing special medicines with a high penicillin content into the patient’s body. The duration of the course is at least two weeks. For greater digestibility, an additional dose of probenicide is prescribed, a substance that inhibits penicillin withdrawal by the kidneys. In cases where patients are allergic to this therapeutic substance, they need to take ceftriaxone. The first day of treatment with this substance is characterized by a more vivid expression of symptoms from the side of neurology, an increase in body temperature, increased heart rate and an intolerable headache. At the same time, the use of anti-inflammatory drugs and corticosteroids is added to penicillin.

The effectiveness of therapy is assessed by the degree of expression of the symptoms of the disease and improvement of the state of the cerebrospinal fluid. After treatment, patients are monitored for the next two years, by examining the cerebrospinal fluid every six months. If there are new signs or worsening of old ones, a repeated course of drug therapy is prescribed.

In the early stages, the disease can be almost completely eliminated. With significant damage to blood vessels and nerves, some symptoms may remain with the patient for life. Congenital disease leads to life-long deafness, and in some cases — disability.

Specific prevention of the disease does not exist. It is necessary only to be attentive to the performance of personal hygiene procedures, to refuse unprotected sexual acts, not to use common devices and things with an infected person. To prevent the emergence of an inborn type of pathology, the expectant mother should not miss scheduled examinations from an obstetrician-gynecologist.