In simple words: Neurosyphilis is a serious complication of untreated syphilis that affects the brain and spinal cord. Symptoms may include problems with thinking, walking, vision, bladder control, and other nervous system functions. It can be treated with antibiotics, but some damage may be permanent.

Symptomatic neurosyphilis is a form of syphilis that involves the central nervous system, including the brain and spinal cord.It typically arises years after the initial syphilis infection if left untreated. Symptoms can vary widely but may include cognitive impairment (e.g., dementia, confusion), behavioral changes, vision or hearing loss, headache, stiff neck, nausea, vomiting, unsteady gait (ataxia), paralysis, sensory loss, and urinary incontinence. Diagnosis is based on a combination of physical examination, patient history (including exposure to syphilis), blood tests (including serological tests for syphilis), and cerebrospinal fluid analysis.Imaging studies like CT scans, MRI, and cerebral angiograms may also be used. Treatment typically involves intravenous or intramuscular penicillin, sometimes in conjunction with probenecid.Ceftriaxone is an alternative antibiotic treatment option.

Example 1: A patient presents with progressive dementia, personality changes, and unsteady gait.Blood tests and CSF analysis confirm neurosyphilis., A patient with a history of untreated syphilis develops sudden vision loss and headache.Imaging reveals signs of meningovascular syphilis., An HIV-positive patient experiences numbness and tingling in their legs, along with urinary incontinence.Testing reveals symptomatic neurosyphilis.

Documentation should include evidence of syphilis infection (e.g., positive serological tests), neurological symptoms, results of CSF analysis, and response to treatment.