Clinical and laboratory characteristics in patients suffering from general paresis in the modern era

J Neurol Sci. 2015 Mar 15;350(1-2):79-83. doi: 10.1016/j.jns.2015.02.021. Epub 2015 Feb 17.

Abstract

Background: No gold standard currently exists for the diagnosis of general paresis (GP), thus often resulting in unnecessarily delayed therapeutic decision.

Methods: A retrospective chart review was performed for 85 inpatients with GP in Zhongshan Hospital, Medical College of Xiamen University, and the characteristics of their clinical profiles, serum and cerebrospinal fluid (CSF) examinations, neuroimaging examination, and electroencephalogram (EEG) data were analyzed.

Results: Among the 85 GP patients, the clinical symptoms that were frequently observed upon admission included a variety of psychiatric-behavioral symptoms and varying degrees of cognitive impairment. All of the patients had positive serum Treponema pallidum particle agglutination (TPPA) assays, 96.47% of the patients had positive CSF TPPA assays, and 41.18% of the patients had both CSF pleocytosis and elevated CSF protein levels. Focal atrophy in one cerebral region or in multiple regions was evident in neuroimages. The EEG data primarily showed slightly abnormal EEG activity.

Conclusion: These results demonstrate the complexity of the clinical characteristics of GP and highlight the importance of early diagnosis.

Keywords: Cerebrospinal fluid; Clinical presentation; Diagnostic criteria; General paresis; Laboratory characteristics; Neurosyphilis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Electroencephalography / trends
  • Female
  • Humans
  • Magnetic Resonance Imaging / trends
  • Male
  • Middle Aged
  • Neurosyphilis / blood*
  • Neurosyphilis / diagnosis*
  • Neurosyphilis / physiopathology
  • Retrospective Studies
  • Tomography, X-Ray Computed / trends
  • Treponema pallidum / isolation & purification*