Syphilis | Stages, Symptoms, Treatment & Prevention

2- Disorders of the central nervous system

In general terms, this is another related disease known as neurosyphilis. It consists of a superposition of parenchymal disturbances in the vascular lining of the meninges. As it is part of the third stage of initial syphilis, it can be asymptomatic at first because patients may not have clinical manifestations but will have brain and spinal fluid abnormalities. These abnormalities include pleocytosis, increased protein, decreased glucose, or positive response in the VDRL test, which makes the lumbar puncture necessary if we want to diagnose this health problem.

Neurosyphilis is the consequence of the damage to the blood vessels of the meninges, brain, spinal cords, etc. The parenchyma is affected as well, and undergoes severe destruction of nerve cells, especially in the cerebral cortex. This area of the brain is in charge or regulating the movement of the body and coordinating cognitive function. Thus, patients with neurosyphilis may experience paresis (weakened movements), aphasia (difficulty to control movement), and many different psychiatric manifestations.

Neurosyphilis is a complication of syphilis that requires a differential diagnosis with others diseases, such as tuberculosis, fungal infections, tumors, subdural hematoma, chronic alcoholism, etc. Given the variable presentation of neurosyphilis, the diagnosis may be difficult, although the demonstration of specific antibodies treponemal in the cerebrospinal fluid helps doctors reach an accurate diagnosis faster.

Tabes dorsalis is yet another damage mainly caused by demyelination of the posterior column, ganglia and dorsal roots. They are typically covered by myelin sheath, a substance that isolates nerve cells just as cables are wrapped by a plastic material. The myelin sheath is important to make the nerve impulse faster, and demyelination in tabes dorsalis leads to poor nerve transmission and many problems, including ataxia, paresthesia (numbness and tingling in the extremities), fecal incontinence, sexual impotence, etc. Cranial nerves may also be affected and the auditory and visual function may be altered at any stage of the disease, especially in the case of congenital syphilis.