Syphilis refers to a sexually transmitted disease that disrupts the functioning of some systems of internal organs. In the absence of competent treatment, after a short period of time, neurosyphilis can develop, characterized by the penetration of infection into the nervous system. This is a very dangerous pathology for human health, threatening complete disability or death.
What is neurosyphilis?
Under neurosyphilis refers to an infectious disease of the human central nervous system. The development of pathology is due to the penetration of the causative agent of syphilis into the body. Infection can involve all parts of the nervous system in the pathological process, from the brain to the sensory organs. Clinically, the disease manifests itself in a number of neurological disorders: dizziness, muscle weakness, paralysis, cramps, dementia.
They first talked about syphilis in the Middle Ages. In those days, alchemists did not yet know what neurosyphilis is. Crusade participants suffered from the disease. During the centennial war, syphilis was otherwise called the French disease, since the British “brought” it from the mainland. A few decades ago, syphilis was considered a sentence for the infected. Thanks to the rapid development of science, this disease can be cured in a few weeks today. However, neglected forms often cause death. High mortality for neurosyphilis is especially relevant.
The disease can manifest itself at any time during the development of syphilitic infection. Diagnosis is based on the results of serological research methods and clinical manifestations. Narrow-spectrum antibiotics are usually used for treatment. Today, neurosyphilis disease is much less common than in the last century. This is due to an improvement in the quality of diagnostic measures, preventive examinations of the population, and early therapy.
The main causes of infection
The causative agent of neurosyphilis is the pale treponema bacterium. Infection occurs directly from a sick person. As a rule, this happens during unprotected intercourse. A pathogenic microorganism enters the human body through damage to the mucous membranes or skin. Then the infection spreads with the bloodstream.
The body responds to a foreign bacterium by producing antibodies. With a decrease in the blood-brain barrier, pale treponema is introduced into the nervous system. Thus, neurosyphilis gradually develops.
The causes of this pathology can also be non-specific. The development of the disease is facilitated by untimely treatment of early forms of the disease, emotional experiences, decreased immunity, traumatic brain injuries, mental overwork.
The main routes of infection:
- Sexual This is the most common form of transmission. The pathogen penetrates through the mucous membranes and microdamages on the skin. The type of sexual contact usually does not play a special role. The use of barrier contraceptives (condom) reduces the risk of infection, but does not reduce it to zero.
- Blood transfusion (with blood transfusion, dental procedures).
- Household . For infection by domestic means, very close contact with a sick person is required. The transfer through towels, common household items, the use of one razor or brush is not excluded.
- Transplacental (transmission from the mother directly to the fetus).
- Professional . First of all, this applies to medical workers who have constant contact with biological fluids (blood, semen, saliva). Infection is possible during obstetric care, surgical interventions, autopsy.
Any contact with a person infected with neurosyphilis always carries a threat.
Clinical picture
Signs of neurosyphilis can be pronounced or erased when the disease is at an initial stage of development. Among the common symptoms characteristic of the disease, doctors include periodic headaches, fatigue, numbness of the limbs.
Specialists distinguish between an early, late and congenital variant of the disease. The first develops within a few years of infection. Otherwise, it is called mesenchymal, since the vessels and brain membranes are primarily involved in the pathological process. A late form of pathology manifests itself approximately five years after the penetration of pale treponema into the body. It is accompanied by damage to nerve cells and fibers. Congenital neurosyphilis develops as a result of transplacental transmission of infection from mother to fetus and appears during the first months of a child's life.
Early neurosyphilis
This form of the disease usually develops within 2-5 years after the infection enters the body. This condition is accompanied by damage to the membranes and blood vessels of the brain. Its main manifestations include syphilitic meningitis, meningovascular syphilis and latent neurosyphilis. The symptoms and characteristic signs of each form will be considered in more detail below.
- Asymptomatic (latent) neurosyphilis can be called a "random" finding. In this state, characteristic symptoms are not observed, and the diagnosis can be established only by a change in the composition of the cerebrospinal fluid.
- Syphilitic meningitis is most often diagnosed in young people. Among the primary symptoms are nausea and vomiting, severe headaches. Body temperature rises extremely rarely. It is possible to involve cranial nerves in the pathological process, which is manifested by visual impairment and the development of sensorineural hearing loss.
- Meningovascular syphilis is characterized by circulatory disorders in the brain. Clinically, pathology is manifested by impaired sensitivity, increased reflexes, decreased attention, and memory impairment. Lack of timely treatment can lead to ischemic stroke. Usually it is preceded by severe headaches, poor sleep, and epileptic seizures are possible .
Late neurosyphilis
This pathology is also divided into several forms:
- Progressive paralysis.
- Dorsal dryness.
- Gummous neurosyphilis.
- Atrophy of the optic nerve.
- Meningovascular neurosyphilis (symptoms similar to an early form of the disease).
When it comes to progressive paralysis, chronic meningoencephalitis is implied. Usually it develops after 5-15 years from the moment of infection with syphilis. The main reason for this form of the disease is the penetration of pale treponema into brain cells with their subsequent destruction. Initially, patients show changes in higher nervous activity (impaired attention and memory, irritability). As the disease progresses, mental disorders (depression, delusions and hallucinations) join in. Symptoms of a neurological nature include tremor of the tongue, dysarthria, and a change in handwriting. The disease develops rapidly and leads to death within a few months.
With damage to the posterior roots and cords of the spinal cord, doctors talk about spinal cord. Clinically, pathology is manifested in the form of loss of Achilles reflexes, instability in the Romberg position. As a result, the person’s gait changes. The occurrence of atrophy of the optic nerve is not excluded. Another characteristic feature of the disease are trophic ulcers.
Atrophy of the optic nerve in some cases acts as an independent form of such an ailment as neurosyphilis. The consequences of the disease significantly reduce the quality of human life. The initial pathological process affects only one eye, but after a while it becomes bilateral in nature. Visual acuity decreases. In the absence of timely treatment, complete blindness develops.
Gummous neurosyphilis. Gummas are rounded formations that form as a result of inflammation caused by treponema. They affect the brain and spinal cord, squeezing the nerves. Clinically, pathology is manifested by paralysis of the limbs and pelvic disorders.
Congenital Neurosyphilis
This form of pathology is extremely rarely diagnosed. During pregnancy, the future woman in labor is repeatedly examined for infections. If intrauterine infection has occurred, it is very easy to recognize. The clinical picture is characterized by the same symptoms as in adult patients, with the exception of spinal cord.
The congenital form of the disease has its own distinctive symptoms. This is hydrocephalus and the so-called Hutchinson triad: deafness, keratitis and deformation of the upper incisors. Timely treatment allows you to stop the infection process, but neurological symptoms persist throughout life.
Diagnosis of neurosyphilis
What is neurosyphilis, we have already said. How to confirm this disease? A final diagnosis is possible taking into account three main criteria: a characteristic clinical picture, results of tests for syphilis, detection of changes in the composition of cerebrospinal fluid. An adequate assessment of the patient's condition is permissible only after a neurological examination.
As for laboratory research, they are carried out comprehensively. In some cases, repeated testing is required. The most informative methods of laboratory diagnostics include RPR analysis, RIBT, RIF, as well as the identification of the causative agent of infection in the contents of affected skin areas.
In the absence of pronounced symptoms, a lumbar puncture is performed. With neurosyphilis in the cerebrospinal fluid, an increased level of protein and the causative agent of the disease, pale treponema, is detected.
MRI and CT of the spinal cord are prescribed to all patients with suspected neurosyphilis. Diagnosis through special devices allows you to detect hydrocephalus and atrophy of the brain substance.
How to defeat neurosyphilis?
Treatment of early forms of the disease is based on aggressive antibacterial therapy. For this, penicillin and cephalosporin preparations are used. As a rule, therapy is complex and involves the use of several drugs at the same time. The usual scheme: Penicillin, Probenecid, Ceftriaxone. All drugs are administered intravenously. Penicillin injections are also done in the spinal canal. The course of treatment usually lasts two weeks. After this, the patient undergoes a second examination, according to the results of which one can judge whether neurosyphilis was able to defeat. Treatment is prolonged if pale treponema is found in the cerebrospinal fluid.
On the first day of drug therapy, neurological symptoms (headache, fever, tachycardia) may intensify. In such cases, treatment is supplemented with anti-inflammatory and corticosteroid drugs.
To combat the late form of neurosyphilis, drugs with arsenic and bismuth are used, which are highly toxic.
Forecast and consequences
The early forms of neurosyphilis respond well to therapy, a complete recovery is possible. In some cases, the so-called residual effects in the form of dysarthria and paresis persist, which can cause disability.
Later forms of pathology respond poorly to drug therapy. Symptoms of a neurological nature, as a rule, remain with the patient for life.
Progressive paralysis a few years ago led to death. Today, the use of penicillin antibiotics can alleviate the onset of symptoms and slow down neurosyphilis.
Photos of patients with such a diagnosis and after a course of treatment make it possible to understand what threat pathology poses to the body. That is why everyone should know how to prevent this ailment.
Preventive measures
To prevent infection, doctors recommend abandoning uncontrolled sexual relations. Special attention should be paid to personal hygiene. People infected with pale treponema must undergo preventive examinations by a neurologist.
What is neurosyphilis? This is a dangerous disease characterized by damage to the central nervous system. In the absence of timely treatment, there is a high probability of developing life-threatening complications that directly affect the quality of life, and sometimes lead to death. Therefore, the prevention of the disease should not be neglected, and after infection, immediately seek help from a doctor.