Stigma of occurring at birth include hydrocephalus, mental retardation, seizures, Chorioretinitis, atrophy optics and nerve deafness. These can be associated with other congenital syphilis evidence. Participation neurological develop later in congenital syphilis may take the form of injuries meningovascular, optic atrophy, tabes or GPI. The parenchymal lesions occur late at a much younger age (minor, GPI juvenile tabes).
Diagnosis: Neurosyphilis should be considered in the differential diagnosis of neurological disorders. GPI must differentiate disorders strokes, main dementias, space intra-beats injury and progressive degenerative lesions of occupation.Tabes should be considered in the differential diagnosis of lesions such as diabetic, toxic and nutritional neuropatheis heredofamilial, ataxia and siringomielia.Presencia Argyll Robertson pupil is a strength to support the diagnosis of neurosyphilis.
Diagnostic laboratory; Serology blood is positive in 60-70% of cases. Changes in the CSF are present in many.These include, Lymphocytic pleocytosis rises in proteins and curve colloidal gold one positive her (which can be tabetic or paretic) .the CSF changes depend on the disease activity. Pre-treatment tends to minimize disruptions.
Prognosis: Treatment can clarify meningovascular injury completely. The results are poor in cases established atrophy tabes and optc. GPI may occur a considerable improvement.
Treatment: It manages a penicilina.Cursos repeated may be required and this has to be decided depending on blood and CSF serology repeated at 6 and 12 months after the initial treatment. Dolores tabetic may respond to analgesics and carbamazepine in a dose of 100 mg three times daily. Visceral crisis discusses sedation and support measures.
Gumma central nervous system
Gumma occurs in the third stage of syphilis. pathologically, the Gumma consist of deposition of collagen, forming an amorphouse matric lymphocytes and multinucleated giant cells in the Center and edge plasma cells. T.pallidum is not provable in these lesiones.Marcelaa can be seen in various situations Cranial Dural, leptomeningeal, cerebral and spinal vertebral.estas behave like space-occupying lesions. antisyphilitic treatment response is poor.Line of treatment is excise duty injuries and give antisyphilitic therapy.
Syphilitic deafness: deafness may derive several reasons at different stages of the sifilis.puede result of affection of the cochlea, acoustic nerve, basal meninges or damage in ear half.
Slow virus infections
Some viruses are able to stay inactive in nervous tissue for long periods and produce damage during several years.These are characterized by long period of incubation, slow course progressive and in many cases a fetal termination.The following two groups are distinguished:
1. In the first group, viral agents are identifiable as Subacute Sclerosing Panencephalitis and progressive, multifocal leuconencephalopathy
2. In the second group, viruses have not been clearly identified, are resistant to antiviral medications, and them not evoke marked antibody response e.g., Kuru and Jakob-Crutzfeldt diseases.
Subacute Sclerosing Panencephalitis (SSPE) is caused by the measles virus.Occurs in children. cause serious anomalies intellectual functions and other motor disturbances and sensoriales.La disease follows a course of 3.9 months end fatalmente.En Kuru and Creutzfeldt Jakob - disease, there is strong evidence of a viral etiology, however, the real viruses have not been progressive multifocal identificados.Leucoencefalopatia (PML) is caused by a virus (SV 40 Jc Virus) Papoa .conduce to progressive demyelination occurring multifocally.PML is seen in partnership with the States of immunocompromised and lymphomas.
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