[Early manifestations of neuromeningeal syphilis. Review of the literature apropos of 3 severe forms].

We report 3 cases of severe syphilitic neuro-meningitis during the secondary stage: acute transverse dorsal myelitis with permanent paraplegia in a 17 year old teenager (case no. 1), uveo-meningitis with intracranial hypertension and diminished vision in a 52 year old woman (case no. 2), lower medulla lesion in a 46 year old man (case no. 3). The diagnosis was based upon highly positive serological tests for syphilis, associated with a compatible clinical context and meningitis in CSF specimens. Treatment was successful in cases nos. 2 and 3, unsuccessful in case no. 1 due to the irreversible character of the medullar lesions. Based on these 3 cases, the following points are discussed: the relatively atypical clinical character in the current context, the difficulties of the diagnosis, and the treatment regimens recommended for neurological syphilis. Despite the rarity of such cases, their extreme severity early in the secondary stage strongly implies the necessity for prevention by detecting and treating early syphilis. Attention is drawn upon the importance of doing serological tests for syphilis when presented with any atypical neurological situation.