Kohler C G, Pickholtz J, Ballas C
Department of Psychiatry, University of Pennsylvania, Philadelphia 19104-4283, USA.
Neuropsychiatry Neuropsychol Behav Neurol. 2000 Oct;13(4):297-302.
The authors present a 30-year-old pregnant and previously healthy woman with sudden onset of agitation, delusions, and frontal lobe dementia. Serum and cerebrospinal fluid findings revealed the presence of untreated syphilis.
Neurosyphilis can present a variety of behavioral symptoms, including mania, depression, and psychosis.
A neuropsychiatric and neurologic workup was performed before the start of antibiotic treatment. The status of the patient was observed throughout the course of her hospital stay for 7 months. Additionally, a neuropsychological evaluation was administered before treatment, and 2 weeks and 4 months after treatment.
After treatment of neurosyphilis, steady improvements were noted in psychotic and cognitive symptoms. By the end of 7 months, and after discontinuation of antipsychotic medication, no psychiatric symptoms were evident.
This case emphasizes the importance of considering neurosyphilis in the differential diagnosis of acute psychosis. Furthermore, this case shows the dramatic improvement in psychiatric symptoms and cognitive dysfunction in response to the treatment of neurosyphilis.
作者报告了一名30岁的孕妇，此前身体健康，突然出现躁动、妄想和额叶痴呆。血清和脑脊液检查结果显示存在未经治疗的梅毒。
神经梅毒可表现出多种行为症状，包括躁狂、抑郁和精神病。
在开始抗生素治疗前进行了神经精神和神经学检查。在患者住院7个月的整个过程中观察其病情。此外，在治疗前、治疗后2周和4个月进行了神经心理学评估。
神经梅毒治疗后，精神病性和认知症状稳步改善。到7个月末，停用抗精神病药物后，未出现明显的精神症状。
该病例强调了在急性精神病鉴别诊断中考虑神经梅毒的重要性。此外，该病例显示了神经梅毒治疗后精神症状和认知功能障碍的显著改善。
