NEUROSYPHILIS

Neurosyphilis is one of the final (tertiary) stages of syphilis. 

What’s tertiary syphilis?

About 10 years after the chancre goes away, roughly one quarter of syphilis patients get tertiary syphilis. Some get disfiguring skin symptoms (gummas), others get cardiovascular disease (thoracic aortic aneurysm), and about 5% get neurosyphilis. The second stage is transient and mild palm/sole redness btw.

What are the symptoms of neurosyphilis? 

• Tabes dorsalis - epicritic loss and proprioceptive loss (ataxic gait). DTRs also lost. See image below.

• Argyll Robertson Pupil - pupil accommodates when cross eyed, but doesn’t accommodate to light. 

• Late stage dementia from overall brain atrophy.