Neurosyphilis

Neurosyphilis, infection of the CNS by T.pallidum can occur at any stage of infection 

Symptoms & Signs 

Fever,  eye pain, redness, photophobia, vision loss, uveitis, iritis, hearing loss,  cranial nerve abnormalities (especially cranial nerves II, III, IV, VI, VII, and VIII), meningismus 

Tabes dorsalis: It results from damage to the posterior columns of the spinal cord 

It presents with sensory ataxia, impairment of proprioception and vibration sense, a wide-based gait with impaired balance that is exacerbated by eye closure (the Romberg sign), muscular hypotonia, hyporeflexia, paresthesias, analgesia, or sharp, agonizing,  (‘shooting’/ ‘lightning) pains in the muscles of the leg, painful bladder spasms, urinary incontinence, impotence,  footdrop, and loss of reflexes.

-It can be accompanied by an Argyll Robertson pupil (which accommodates, but does not react to, light, light-near disassociation phenomenon) and optic atrophy 

-Painless trophic ulcers may develop over pressure points on the feet. 

-Sensory loss and hypotonicity can lead to the occurrence of hypertrophic (Charcot) joints. 

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