Akıncı Erhan, Öncü Fatih, Topçular Barış
Turk Psikiyatri Derg. 2017 Spring;28(1):61-66.
Syphilis is a generally sexually transmitted and multisystem disease caused by the spirochete Treponema pallidum. All of the organs of the body may be involved during the course of the disease. Neurosyphilis is a clinical form of syphilis with the central nervous system (CNS) involvement. While primarily meningeal and vascular structures are involved in early neurosyphilis, a parenchymal affection of the brain and spinal cord emerges at later stages of neurosyphilis. It presents with symptoms of meningitis, meningovasculitis and parenchymal neurosyphilis (presenting as tabes dorsalis and general paresis). Clinically, it can mimic a variety of psychiatric disorders such as depression, psychosis, mania, delirium, personality changes and dementia. During its progression making presentations similar to many systemic or neuropsychiatric diseases, syphilis is defined as "great imitator". Nowadays, neurosyphilis is a rare disease as a result of the widespread use of antibiotics that must be kept in mind in the differential diagnosis of neurological and psychiatric disorders. In this article, three neurosyphilis cases with different psychiatric presentations are reported and literature relevant to syphilis are reviewed.
梅毒是一种由梅毒螺旋体引起的通常通过性传播的多系统疾病。在疾病过程中,身体的所有器官都可能受累。神经梅毒是梅毒的一种临床形式,累及中枢神经系统(CNS)。早期神经梅毒主要累及脑膜和血管结构,而在神经梅毒的后期会出现脑和脊髓的实质病变。它表现为脑膜炎、脑膜血管炎和实质神经梅毒的症状(表现为脊髓痨和全身麻痹)。临床上,它可以模仿多种精神障碍,如抑郁症、精神病、躁狂症、谵妄、人格改变和痴呆。在其发展过程中,梅毒的表现与许多全身性或神经精神性疾病相似,因此被定义为“伟大的模仿者”。如今,由于抗生素的广泛使用,神经梅毒是一种罕见疾病,在神经和精神障碍的鉴别诊断中必须予以考虑。本文报告了三例具有不同精神表现的神经梅毒病例,并对与梅毒相关的文献进行了综述。