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Neuropsychiatric disorders secondary to neurosyphilis in elderly people: one theme not to be ignored

Published online by Cambridge University Press:  21 June 2013

Yan-Li Zeng
Affiliation:
Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
Wen-Jie Wang
Affiliation:
Department of Neurology, Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
Hui-Lin Zhang
Affiliation:
Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
Fu-Yi Chen
Affiliation:
Department of Physiology and Neurobiology, University of Connecticut, Storrs, Connecticut, USA
Song-Jie Huang
Affiliation:
Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
Gui-Li Liu
Affiliation:
Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
Ya Xi
Affiliation:
Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
Xiao-Jing Guo
Affiliation:
Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
Wei-Hong Zheng
Affiliation:
Department of Neurology, Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
Tian-Ci Yang
Affiliation:
Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
Corresponding

Abstract

Background:

Neurosyphilis (NS) may present with neuropsychiatric disorders characterized by cognitive impairment, personality disorders, and confusion, among others. Very few studies have focused on neuropsychiatric disorders secondary to NS in elderly people.

Method:

A retrospective chart review was performed to characterize the psychiatric findings, clinical signs and symptoms, laboratory findings, and brain magnetic resonance imaging results of ten elderly inpatients with NS.

Results:

In these ten patients, the most common presenting symptoms included a wide variety of psychiatric manifestations. The serum rapid plasma regain (RPR) and Treponema pallidum particle agglutination assay (TPPA) of the ten patients were positive, with positive CSF TPPA and RPR rates of 100% and 60%, respectively. In addition, 90% of the patients demonstrated abnormal imaging, including cerebral atrophy, infarct ischemic stroke, and hydrocephalus.

Conclusions:

Our findings support the importance of serological tests for syphilis as a routine component of the evaluation of patients with clinically evident neurological or psychiatric symptoms. If the serology is positive, all of the patients should be examined with a lumbar puncture. Moreover, psychiatric illnesses secondary to NS in the elderly also deserve medical attention.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

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