Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China.
Int Psychogeriatr. 2013 Sep;25(9):1513-20. doi: 10.1017/S1041610213000896. Epub 2013 Jun 21.
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.
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.
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.
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.
神经梅毒（NS）可能表现为认知障碍、人格障碍和意识混乱等神经精神障碍。很少有研究关注老年人继发于 NS 的神经精神障碍。
对 10 例老年住院 NS 患者的精神科发现、临床体征和症状、实验室检查和脑磁共振成像结果进行回顾性图表分析。
在这 10 例患者中，最常见的首发症状包括各种精神症状。10 例患者的血清快速血浆反应素（RPR）和梅毒螺旋体颗粒凝集试验（TPPA）均为阳性，CSF TPPA 和 RPR 的阳性率分别为 100%和 60%。此外，90%的患者表现出异常影像学改变，包括脑萎缩、梗死性缺血性卒中和脑积水。
我们的研究结果支持梅毒血清学检查作为有临床明显神经或精神症状患者评估的常规组成部分的重要性。如果血清学检查阳性，所有患者均应进行腰椎穿刺检查。此外，老年人继发于 NS 的精神疾病也需要引起重视。
