Neurosyphilis in the Modern Era: A Case Series

Ten cases of syphilis with central nervous system involvement were reported.All patients had HIV-negative status.Seven patients tested positive for treponemal antibodies in both serum and CSF.Five patients had progressive dementia with prominent psychiatric symptoms.All developed extrapyramidal syndrome after exposure to antipsychotic medication.Two patients had meningo-encephalitic illness.Neuro-imaging showed cortical atrophy more marked at the frontotemporal region with ventricular prominence.CSF revealed increased protein and lymphocytic pleocytosis.One patient presented with recurrent stroke.None of them improved due to the advanced state of disease.Multisegmental demyelination noted in 2 patients predominantly involving the dorsal cord, they were tested positive in serum only.One had a good recovery and the other showed no improvement in deficit.