Browse A-Z
More <
bookmarks-menu

Neurosyphilis

Show Alternative Names
Syphilis - neurosyphilis

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

Neurosyphilis is caused by Treponema pallidum bacteria. Neurosyphilis usually occurs about 10 to 20 years after a person is first infected with syphilis. Not everyone who has syphilis develops this complication.

There are four different forms of neurosyphilis:

Asymptomatic neurosyphilis occurs before symptomatic syphilis. Asymptomatic means there aren't any symptoms.

Symptoms

Symptoms usually affect the nervous system. Depending on the form of neurosyphilis, symptoms may include any of the following:

  • Abnormal walk (gait), or unable to walk
  • Numbness in the toes, feet, or legs
  • Problems with thinking, such as confusion or poor concentration
  • Mental problems, such as depression or irritability
  • Headache, seizures, or stiff neck
  • Loss of bladder control (incontinence)
  • Tremors, or weakness
  • Visual problems, even blindness

Exams and Tests

Your health care provider will do a physical examination and may find the following:

Blood tests can be done to detect substances produced by the bacteria that cause syphilis, this includes:

  • Treponema pallidum particle agglutination assay (TPPA)
  • Venereal disease research laboratory (VDRL) test
  • Fluorescent treponemal antibody absorption (FTA-ABS)
  • Rapid plasma reagin (RPR)

With neurosyphilis, it is important to test the spinal fluid for signs of syphilis.

Tests to look for problems with the nervous system may include:

Treatment

Penicillin (an antibiotic) is used to treat neurosyphilis. It can be given in different ways:

  • Injected into a vein several times a day for 10 to 14 days.
  • By mouth 4 times a day, combined with daily muscle injections, both taken for 10 to 14 days.

You must have follow-up blood tests at 3, 6, 12, 24, and 36 months to make sure the infection is gone. You will need follow-up lumbar punctures for CSF analysis every 6 months. If you have HIV/AIDS or another medical condition, your follow-up schedule may be different.

Outlook (Prognosis)

Neurosyphilis is a life-threatening complication of syphilis. How well you do depends on how severe the neurosyphilis is before treatment. The goal of treatment is to prevent further deterioration. Many of these changes will be permanent.

Possible Complications

The symptoms can slowly worsen.

When to Contact a Medical Professional

Contact your provider if you have had syphilis in the past and now have signs of nervous system problems.

Prevention

Prompt diagnosis and treatment of the original syphilis infection can prevent neurosyphilis.

Review Date: 11/10/2024

Reviewed By

Jatin M. Vyas, MD, PhD, Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

National Institute of Neurological Disorders and Stroke website. Neurosyphilis. www.ninds.nih.gov/health-information/disorders/neurosyphilis. Updated July 19, 2024. Accessed November 27, 2024.

Radolf JD, Tramont EC, Salazar JC. Syphilis (Treponema pallidum). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 237.

Disclaimer

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- 2025 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Images
Central nervous system and peripheral nervous system - Illustration Thumbnail

Central nervous system and peripheral nervous system

The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.

Illustration

Late-stage syphilis - Illustration Thumbnail

Late-stage syphilis

Tertiary syphilis is a late stage of the disease which can follow the initial infection, primary syphilis, by several years. Pockets of damage accumulate in various tissues such as the bones, skin, nervous tissue, heart, and arteries. These lesions are called gummas and are very destructive.

Illustration

 
 
 
 
 
 

 

 
 
 
URAC Seal
Health Content Provider
06/01/2025
A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics. This site complied with the HONcode standard for trustworthy health information from 1995 to 2022, after which HON (Health On the Net, a not-for-profit organization that promoted transparent and reliable health information online) was discontinued.
© 1997-2025ADAM Company Logo All rights reserved.