CNS INFECTIONS-NEUROSYPHILIS

SUMMARY

1. Both secondary and tertiary syphilis can affect the cord.

2. The secondary manifestation of meningovascular syphilis can present as infarction of the spinal cord (rare).

3. Tertiary syphilis presents as cognitive impairment, tabes dorsalis, and/or aortitis.

4. The cognitive impairment can be remembered by the mnemonic PARESIS: personality, affect, reflexes, eyes (Argyll-Robertson pupil), sensorium, intellect, speech.

5. Tabes dorsalis is syphilitic involvement of the posterior columns that causes deficits in proprioception, manifesting as ataxia and paresthesias.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].