Congenital Neurosyphilis, Gumma of the Central Nervous System and Slow Virus Infections
The stigmata present at birth include hydrocephalus, mental retardation, seizures, chorioretinitis, optic atrophy, and Nerve Control 911 by PhytAge Labs (simply click www.bellevuereporter.com) deafness. These might be connected with other evidences of congenital syphilis. Neurological management developing later in congenital syphilis may take the form of meningovascular lesions, optic atrophy, tabes dorsalis or GPI. The late parenchymal lesions occur at a substantially younger age (juvenile GPI, juvenile tabes).
Diagnosis: Neurosyphilis should be considered in the differential investigation of all neurological disorders. GPI needs to be differentiated from cerebrovascular problems, primary dementias, intra-cranial room occupying lesions and progressive degenerative lesions. Tabes dorsalis must be considered in the differential examination of lesions like diabetic, toxic and nutritional neuropatheis, heredofamilial, ataxias and syringomyelia. Presence of Argyll Robertson pupil is definitely a strong point to support the investigation of neurosyphilis.
Lab diagnosis; Blood serology is good in 60-70 % of cases. The CSF changes are existing in most. These include lymphocytic pleocytosis, rise in proteins and a good Lange’s colloidal gold curve (which could be paretic or tabetic). The CSF changes count on the activity of the illness. Previous treatment tends to reduce the abnormalities.
Prognosis: Treatment could clear up meningovascular lesion totally. The results are poor in established cases of tabes and optc atrophy. In GPI extensive improvement may occur.
Treatment: Penicillin is provided. Repeated courses might be required and this also has to be decided depending upon blood as well as CSF serology repeated at six as well as 12 weeks after initial therapy. Tabetic pains may respond to analgesics and carbamazepine in a dose of 100mg thrice daily. Visceral crises are handled by sedation and supportive measures.
Gumma of the main nervous system
Gumma happens in the third stage of syphilis. Pathologically, the gumma contain collagen deposition developing an amorphouse matric with lymphocytes as well as plasma cells at the periphery and multinucleated huge cells in the middle. T.Pallidum just isn’t demonstrable within these lesions. Gumma might be seen in various situations cranial, leptomeningeal, dural, cerebral and spinal. These behave like space occupying lesions. response to antisyphilitic care is poor. Line of management is to excise the lesions and give antisyphilitic therapy.
Syphilitic deafness: Deafness may result from several reasons in the different stages of syphilis. It may originate from affection of the cochlea, acoustic nerve, basal meninges or harm to the middle ear.
Gradual virus infections