Clinical spectrum of neurosyphilis in North East India

Kayal, Ashok K; Goswami, Munindra; Das, Manas; Paul, Biswajit

doi:10.4103/0028-3886.82719

Cited by 26 publications

(17 citation statements)

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“…[21] We have reported ATM, CM, and amyotrophy as manifestations of spinal syphilis from our institution previously. [30] The patient of cryptococcal myelitis had close contact with pigeons and hens. Although we considered the possibility of viral (CMV, VZV), tuberculous, and fungal infection in a patient of radiculomyelitis with HIV infection, CSF analysis was not confirmatory.…”

Section: Discussionmentioning

confidence: 99%

Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India

Kayal

Goswami

Das

et al. 2017

Ann Indian Acad Neurol

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Background:The discovery of antibodies against aquaporin-4 and evolving concepts of noncompressive myelopathies in the 21st century have made a major impact on the etiological profile of these diseases, with few cases turning out to be idiopathic.Objective:To find causes of noncompressive myelopathy in a tertiary care hospital of Northeast India.Materials and Methods:An observational study was carried out in the Neurology Department of Gauhati Medical College, Guwahati, from September 2013 to February 2016. Patients of noncompressive myelopathies who underwent magnetic resonance imaging (MRI) of the spine were segregated into two categories: acute-to-subacute myelopathy (ASM) and chronic myelopathy (CM). In addition to routine blood tests, chest X-ray, urinalysis, and visual evoked potentials, investigations included MRI of the brain, cerebrospinal fluid analysis, and immunological, infectious, and metabolic profile based on the pattern of involvement.Results:The study had 151 patients (96 ASM and 55 CM) with a median age of 35 years and male: female ratio 1.4:1. The causes of ASM were neuromyelitis optica spectrum disorder (23), multiple sclerosis (MS) (8), systemic lupus erythematosus (1), Hashimoto's disease (1), postinfectious acute disseminated encephalomyelitis (6), postinfectious myelitis (8), infections (9), spinal cord infarct (5), and electrocution (1). The causes of CM were MS (1), probable or possible sarcoidosis (7), mixed connective tissue disease (1), Hashimoto's disease (2), infections (9), Vitamin B12 deficiency (4), folate deficiency (2), hepatic myelopathy (2), radiation (11), and paraneoplastic (1). No etiology could be found in 48 (31.8%) patients (34 ASM and 14 CM). In 21/96 (21.9%) patients of ASM, acute transverse myelitis was idiopathic based on current diagnostic criteria.Conclusion:Underlying etiology (demyelinating, autoimmune, infectious, vascular, metabolic disorder, or physical agent) was found in 68% patients of noncompressive myelopathy.

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Section: Discussionmentioning

confidence: 99%

Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India

Kayal

Goswami

Das

et al. 2017

Ann Indian Acad Neurol

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“…[5] In a series of nine patients of syphilitic myelopathy by Silber[8] only one patient had Erb's paraplegia. In a series of 16 patients of NS from northeast India,[9] five patients had myelopathy. Amongst them two patients had acute transverse myelitis and chronic myelopathy was present in three patients.…”

Section: Discussionmentioning

confidence: 99%

“…Our patient had spinal cord involvement in the form of Erb's paraplegia along with optic nerve involvement in form of primary optic neuropathy. In the series from northeast India[9] none of the 16 patients of NS had optic nerve involvement.…”

Section: Discussionmentioning

confidence: 99%

Erb′s paraplegia with primary optic atrophy: Unusual presentation of neurosyphilis: Case report and review of literature

Sharma

Nath

Kumawat

et al. 2014

Ann Indian Acad Neurol

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Symptomatic neurosyphilis (NS) can have varied syndromic presentations: Meningitis, meningovascular and parenchymatous involvement. Non-tabetic syphilis affecting the spinal cord is rare and only sporadic case reports have been published. The variant of meningomyelitis known as Erb's paraplegia refers to patients of spinal syphilis with very slow progression over many years and predominantly motor signs. Primary optic atrophy occurs twice as frequently in tabes dorsalis as in other types of NS. We describe here a case of a 32-year-old truck driver who presented with Erb's paraplegia with primary optic atrophy. This clinical overlap in NS is extremely rare and to our knowledge is the first case report of its type.

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“…Psychotic symptoms in correlation with organic mental disorders due to neurosyphilis are substantially discussed in the recent literature [10,26,27,28,29]. Mannekote and Singh [30] describe a case of neurosyphilis, in which the patient presented with treatment-resistant psychotic symptoms, which responded to antibiotic treatment.…”

Section: Resultsmentioning

confidence: 99%

Psychosis in Neurosyphilis - Clinical Aspects and Implications

et al. 2013

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Background: The World Health Organization estimates that 10-12 million new syphilis infections occur each year. Without treatment, years to decades after initial infection, 30% of affected individuals may develop tertiary syphilis, which can manifest as neurosyphilis. The aim of this review is to evaluate the research literature examining the psychopathological manifestations of psychosis in association with neurosyphilis. Method: The authors performed a systematic electronic search for published studies (1995-2012). The following databases were used: Medline, Embase and the Cochrane Library as well as the search engines Scopus and Google Scholar. Results: 61 articles were used for detailed analysis. Psychotic symptoms due to neurosyphilis are numerous and can inform differential diagnosis for many psychotic manifestations according to ICD-10 or DSM-IV. Conclusion: Due to our results, current epidemiological data, and the difficulties in differential diagnosis of neurosyphilis, routine screening tests are still recommended in the psychiatric field. Long-term psychiatric input, with periodic syphilis titre controls, seems indicated in individuals affected by neurosyphilis with psychiatric symptoms. Furthermore, individuals with mental health problems may be at higher risk of acquiring syphilis.

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Clinical spectrum of neurosyphilis in North East India

Abstract: Syphilis can affect any part of the neuraxis. A high index of clinical suspicion is required to diagnose NS and institute the treatment early, particularly in patients with promiscuous sexual behavior.

Cited by 26 publications

References 0 publications

Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India

Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India

Erb′s paraplegia with primary optic atrophy: Unusual presentation of neurosyphilis: Case report and review of literature

Psychosis in Neurosyphilis - Clinical Aspects and Implications

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