The stigmata present at birth include hydrocephalus, mental retardation, seizures, chorioretinitis, optic atrophy, and nerve deafness. These could be associated with different evidences of congenital syphilis. Neurological involvement developing later in congenital syphilis may take the kind of meningovascular lesions, optic atrophy, tabes dorsalis or perhaps GPI. The late parenchymal lesions occur at a significantly younger age (juvenile GPI, juvenile tabes).
Diagnosis: Neurosyphilis should be considered in the differential diagnosis of all neurological disorders. GPI must be differentiated from cerebrovascular problems, main dementias, intra cranial room occupying lesions and progressive degenerative lesions. Tabes dorsalis has to be viewed in the differential diagnosis of lesions including diabetic, toxic and nutritional neuropatheis, heredofamilial, syringomyelia and ataxias. Presence of Argyll Robertson pupil is an extremely strong thing to support the diagnosis of neurosyphilis.
Lab diagnosis; Blood serology is positive in 60-70 % of cases. The CSF changes are present in a lot of. These normally include lymphocytic pleocytosis, increasing amount of proteins in addition to a positive Lange's colloidal gold curve (which may be tabetic or paretic). The CSF changes depend on the activity of the illness. Previous treatment has a tendency to reduce the abnormalities.
Prognosis: Treatment may clear up meningovascular lesion completely. The results are poor in established cases of optc atrophy and tabes. In GPI extensive improvement might occur.
Treatment: Penicillin is given. Repeated courses may be required and this also has to be decided depending upon blood and CSF serology repeated at six and twelve months after initial therapy. Tabetic pains may react to analgesics as well as carbamazepine in a dose of 100mg thrice every day. Visceral crises are handled by sedation and supportive measures.

Gumma of the central nervous system

Gumma of the main nervous system
Gumma happens in the last stage of syphilis. Pathologically, the gumma contain collagen deposition creating an amorphouse matric with lymphocytes as well as plasma cells at the periphery and multinucleated huge cells in the middle. T.Pallidum isn't demonstrable in these lesions. Gumma may be seen in a variety of situations cranial, dural, leptomeningeal, cerebral and spinal. These behave like space occupying lesions. reaction to antisyphilitic treatment is terrible. Line of management is usually best prescription alternative to adderall excise the lesions and give antisyphilitic therapy.
Syphilitic deafness: Deafness may well result from a number of reasons in the different stages of syphilis. It may come from passion of the cochlea, acoustic nerve, basal meninges or perhaps harm to the middle ear.

Slow virus infections