Neurosyphilis is a complication of syphilis, and arises when the bacteria Treponema pallidum invades the nervous system, reaching the brain, meninges and spinal cord. This complication usually arises after many years of living with the bacteria without proper treatment, which leads to the appearance of signs and symptoms such as memory failure, depression, paralysis or seizures.
To treat neurosyphilis, the doctor will recommend antibiotic medications, such as crystalline Penicillin, directly in the vein, for approximately 10 to 14 days. After a few months of treatment, it will be necessary to monitor the levels of infection through lumbar puncture of the cerebrospinal fluid to assess whether there has been a cure.
Syphilis is a chronic infectious disease acquired mainly through sexual contact, and can evolve in different ways over different stages, including the formation of genital ulcers, skin blemishes or fever, for example, with serious changes such as heart problems or Neurological events occur in more advanced stages of the disease. Find out more about the stages of syphilis in Everything about syphilis.
The first signs and symptoms of neurosyphilis usually appear between 5 to 20 years after infection by Treponema pallidum, only when the infected person has not received adequate treatment in this period. Some of the main signs and symptoms include:
- Vision disorders and blindness;
- Memory failures and dementia;
- Change in gait;
- Urinary incontinence;
- Mental confusion;
- Stiff neck;
- Numbness in the legs and feet;
- Difficulty concentrating;
- Progressive general paralysis;
- Personality changes;
- Pupils not responsive to light;
- Alteration in nervous reflexes.
As the signs and symptoms of neurosyphilis are very varied, this disease can be confused with several neurological diseases, such as Alzheimer’s, multiple sclerosis, meningitis, brain tumor, Parkinson’s disease, stroke (stroke) or psychiatric illnesses, such as schizophrenia and depression.
How to confirm
The diagnosis of neurosyphilis is made by analyzing CSF, or cerebrospinal fluid, which shows alterations suggestive of the disease, and is performed through lumbar puncture.
Imaging exams, such as computed tomography, magnetic resonance and cerebral angiography, are highly recommended to assess brain changes and disease progression. Blood tests, such as FTA-ABS and VDRL, are serological tests that help to identify antibodies related to syphilis. Learn how to understand the VDRL exam result.
How the treatment is done
The treatment of neurosyphilis should be carried out in a hospital, consisting of daily injections into the vein of antibiotics such as crystalline Penicillin G or Ceftriaxone, for about 10 to 14 days.
After treatment for neurosyphilis, the doctor can do blood tests at the 3rd and 6th months, as well as once a year, for 3 years. In addition, lumbar punctures can be performed every 6 months to confirm the cure of the infection.
Although most symptoms of neurosyphilis are reversible, when treatment is not done properly, the disease can cause severe changes in the central nervous system, resulting in sequelae that include:
- Paralysis of body regions;
- Vision loss;
- Dementia, persistent changes in memory or behavior
- Sexual impotence;
- Psychosis and other psychiatric disorders;
- Movement disorders
- Urinary incontinence;
- Constant pains.
Complications of neurosyphilis depend on how the disease has progressed in each person, the time of infection and the time to wait for treatment to begin.
Prevention of neurosyphilis
Neurosyphilis is an infection that can have serious health consequences and, therefore, must be prevented through appropriate treatment. Thus, patients with syphilis should follow the doctor’s instructions, preventing the infection from reaching the nervous system, especially in cases of patients with an altered immune system.
The prevention of syphilis is done with the use of condoms during sexual intercourse, and care is taken to avoid contamination through blood and secretions, and materials that may be contaminated, such as syringes and needles, should not be shared, in addition to pre-monitoring. – adequate birth, in the case of pregnant women. Check out more guidance on how transmission occurs and how to prevent syphilis.