Banner image

Neurosyphilis

Syphilis - neurosyphilis

Find

Learn More

Causes

Neurosyphilis is caused by Treponema pallidum. This is the bacteria that causes syphilis. Neurosyphilis usually occurs about 10 to 20 years after a person is first infected with syphilis. Not everyone who has syphilis develops this complication.

There are four different forms of neurosyphilis:

Asymptomatic neurosyphilis occurs before symptomatic syphilis. Asymptomatic means there aren't any symptoms.

Definition

Neurosyphilis is a bacterial infection of the brain or spinal cord. It usually occurs in people who have had untreated syphilis for many years.

Exams and Tests

Your health care provider will do a physical examination and may find the following:

Blood tests can be done to detect substances produced by the bacteria that cause syphilis, this includes:

  • Venereal disease research laboratory (VDRL) test
  • Fluorescent treponemal antibody absorption (FTA-ABS)
  • Rapid plasma reagin (RPR)
  • Treponema pallidum particle agglutination assay (TPPA)

With neurosyphilis, it is important to test the spinal fluid for signs of syphilis.

Tests to look for problems with the nervous system may include:

Outlook (Prognosis)

Neurosyphilis is a life-threatening complication of syphilis. How well you do depends on how severe the neurosyphilis is before treatment.

Possible Complications

The symptoms can slowly worsen.

Prevention

Prompt diagnosis and treatment of the original syphilis infection can prevent neurosyphilis.

Symptoms

Symptoms usually affect the nervous system. Depending on the form of neurosyphilis, symptoms may include any of the following:

  • Abnormal walk (gait), or unable to walk
  • Numbness in the toes, feet, or legs
  • Problems with thinking, such as confusion or poor concentration
  • Mental problems, such as depression or irritability
  • Headache, seizures, or stiff neck
  • Loss of bladder control (incontinence)
  • Tremors, or weakness
  • Visual problems, even blindness

Treatment

The antibiotic penicillin is used to treat neurosyphilis. It can be given in different ways:

  • Injected into a vein several times a day for 10 to 14 days.
  • By mouth 4 times a day, combined with daily muscle injections, both taken for 10 to 14 days.

You must have follow-up blood tests at 3, 6, 12, 24, and 36 months to make sure the infection is gone. You will need follow-up lumbar punctures for CSF fluid analysis every 6 months. If you have HIV/AIDS or another medical condition, your follow-up schedule may be different.

When to Contact a Medical Professional

Call your provider if you have had syphilis in the past and now have signs of nervous system problems.

Review Date: 11/27/2016
Reviewed By: Arnold Lentnek, MD, Infectious Diseases Medical Practice of NY and Clinical Research Centers of CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

ADAM QualityA.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 9-1-1 for all medical emergencies. Links to other sites are provided for information only—they do not constitute endorsements of those other sites. © 1997-2010 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.