Syphilis is still one of the most common STDs (Sexually Transmitted Disease) among developing countries.

General paralysis is an impairment of mental function caused by damage to the brain from untreated syphilis; it is a frequent and serious disease.

A.M. is a 35 years old, married male with primary school education. He lives with his family in Kenitra. His first Complaints occurred two years ago by an attention deficit, auditory hallucinations, difficulty in learning and suspiciousness, and then other psychotic features (Delusions of persecution and reference, state of severe agitation, patient suffering from visual hallucinations, aggressive behavior) added.

There was nothing special in his previous personal and medical histories. In family history a brother had a schizophrenia disorder. This case had been hospitalized several time with various psychiatric diagnosis. Physical examination found to be normal. At the neurological examination, we found tremor. At the psychiatric examination his insight was absent and associations were loose in his thought content there were delusions of persecution and reference, and auditory hallucinations. Atypical features of the clinical picture and cognitive impairment led to further laboratory investigations. Diagnosis was verified with serological tests (VDRL, TPHA) in blood and cerebrospinal fluid (CSF). A cerebral CT scan: brain atrophy more prominent in the Frontal region and major ventricular dilatation. The diagnosis of general paralysis was based on clinical manifestations (delusions and dementia) associated to a positive serology in serum and CSF. Patient was treated by a high dose penicillin-therapy in perfusion and neuroleptics.