NEUROSYPHILIS

NEUROSYPHILIS

CONTAINS :-

1)BASIC INTRODUCTION
2)CAUSES AND RISK FACTORS
3)TYPES OF NEUROSYPHILIS
4)DIAGNOSIS
5)TREATMENT

BASIC INTRODUCTION📝

👉 Neurosyphilis refers to infection of the central nervous system in a patient with syphilis and can occur at any stage.

👉 Syphilis :- is a sexually transmitted infection (STI) that spreads through direct contact with syphilis sores.

👉 If syphilis goes untreated, the affected person is at risk of developing neurosyphilis. This is an infection of the nervous system, specifically of the brain and the spinal cord. Neurosyphilis is a life-threatening disease.

👉 Neurosyphilis is a bacterial infection of the brain or spinal cord. It usually occurs in people who have had untreated syphilis for many years.

CAUSES AND RISK FACTORS  📝

👉 Treponema pallidum is the bacterium that causes syphilis and, subsequently, neurosyphilis. Neurosyphilis tends to develop about 10 to 20 years after the initial infection with the bacterium. Having HIV and untreated syphilis are major risk factors for neurosyphilis.

👉 There are several risk factors: high-risk sexual behavior from unprotected sex and multiple sexual partners.

TYPES OF NEUROSYPHILIS 📝

👉 There are five different forms of neurosyphilis.

1)ASYMPTOMATIC NEUROSYPHILIS
2)MENINGEAL NEUROSYPHILIS
3)MENINGOVASCULAR NEUROSYPHILIS
4)GENERAL PARESIS
5)TABES DORSALIS

👉 ASYMPTOMATIC NEUROSYPHILIS

This is the most common type of neurosyphilis. It usually occurs before the symptoms from syphilis become visible. In this form of neurosyphilis, you won’t feel sick or experience any signs of neurologic disease.

👉 MENINGEAL NEUROSYPHILIS

This form of the disease usually shows up anywhere from a few weeks to a few years after a person contracts syphilis. 

Symptoms include:

- nausea

- vomiting

- a stiff neck

- a headache

- It may also cause a loss of hearing or vision.

👉 MENINGOVASCULAR NEUROSYPHILIS

This is a more serious form of meningeal neurosyphilis. In this case, you would also have had at least one stroke.

About 10 to 12 percent of those with neurosyphilis develop this form. A stroke may occur in the first few months following a syphilis infection, or it may happen a few years after infection.

👉 GENERAL PARESIS

This form can appear decades after you’re infected with syphilis, and it can cause lasting issues. However, it’s fairly rare today because of advances in the screening, treatment, and prevention of STIs.

If it develops, general paresis may lead to several health problems, including:

- paranoia

- mood swings

- emotional troubles

- personality changes

- weakened muscles

- a loss of the ability to utilize language

It can also progress to dementia.

👉 TABES DORSALIS

This form of neurosyphilis is also rare. It can start to affect the spinal cord 20 years or more after the initial syphilis infection.

 Its symptoms include:

- trouble balancing

- a loss of coordination

- incontinence

- an altered walk

- vision problems

- pains in the abdomen, arms, and legs

DIAGNOSIS📝

PHYSICAL EXAM

👉 To find out if you have neurosyphilis, your doctor may start by checking your normal muscle reflexes and determining whether any of your muscles have atrophied (lost muscle tissue).

BLOOD TEST

👉 A blood test can detect middle-stage neurosyphilis. There are a variety of blood tests that will show whether you currently have syphilis or if you had an infection in the past.

SPINAL TAP 

👉 To diagnose neurosyphilis, cerebrospinal fluid (CSF) analysis is required. Lumbar puncture ("spinal tap") is used to acquire CSF. 

👉 If your doctor suspects you have late-stage neurosyphilis, they will also order a lumbar puncture, or spinal tap. This procedure will provide a sample of the fluid around your brain and spinal cord. Your doctor will use this sample to determine the extent of the infection and plan your treatment.

IMAGING TESTS

👉 Your doctor might order a CT scan. This is a series of X-rays that allows your body to be seen in cross sections and from different angles.

CT SCAN 

👉 You might also need an MRI scan. An MRI is a test in which you lie in a tube containing a strong magnet. The machine sends radio waves through your body, allowing your doctor to see detailed images of your organs.

MRI

👉 These tests allow your doctor to look at your spinal cord, brain, and brainstem for evidence of the disease.

TEATMENT📝

👉 Penicillin is used to treat neurosyphilis.
DOSE:-
- Aqueous penicillin G 3–4 million units every four hours for 10 to 14 days.

- One daily intramuscular injection and oral probenecid four times daily, both for 10 to 14 days.

👉 During your recovery, you’ll need blood tests at the three- and six-month marks. After that, you should have blood tests every year for three years following your treatment. Your doctor will continue to monitor your cerebrospinal fluid levels with spinal taps every six months. 

👉 Those with neurosyphilis and HIV usually need more penicillin injections and have a lower chance for complete recovery.

PHYSIOTHERAPY ROLE IN NEUROSYPHILIS

👉 SWD
👉 TENS
👉 Moist Heat
👉 PFM EXERCISE
👉 RELAXITION - EMG bio feedback

- Pulmonary rehabilitation
- Cardiac rehabilitation
- Neuromuscular rehabilitation
- therapeutic exercises
- Feetness/aerobic exercise
- Balance and co-ordination training
- Counseling

HOW TO PREVENT NEUROSYPHILIS

👉 The first step in neurosyphilis treatment is preventing syphilis. Since syphilis is an STI, your best option is to practice safe sex. You can discuss this with your doctor. Condoms can reduce the chance of contracting syphilis. However, syphilis can be contracted through touching genitals outside of the area covered by the condom.

👉 People don’t always know they have been infected with syphilis because symptoms can remain hidden for years. An initial sore or sores at the infection site may appear a few weeks or months after contracting the disease. Although these sores heal on their own, the disease can remain. Later, a rash of rough, not itchy, reddish brown spots will appear at the infection site or on another part of the body. If you plan on being sexually active, get tested for STIs on a regular basis. If you have syphilis, you can pass it on to others, including your unborn baby.

Other symptoms of syphilis include:

- swollen lymph glands
- a headache
- hair loss
- weight loss
- fatigue
- muscle aches

👉 See your doctor to get tested if you have or have had any of these symptoms. The sooner you are diagnosed, the better your chances of avoiding neurosyphilis.