An insidious feature of syphilis is the defeat of vital internal organs and systems. They usually occur in the second stage, but in some patients, characteristic symptoms appear earlier, at the beginning of the development of pathology. One of the most dangerous complications is neurosyphilis, in which an infectious agent penetrates the spinal cord and affects the parts of the nervous system.
General characteristics of the disease
The second name of the pathology is syphilis of the nervous system. Its main manifestations include symptoms of meningitis (inflammation of the brain), paralysis, nerve roots located in the spinal cord. The reasons for such phenomena are the formation of syphilitic gums in these internal organs. Visual examinations and blood tests allow to detect the disease, therapy involves the fight against the causative agent of the disease with antibiotics and symptomatic treatment, rehabilitation after the end of drug treatment.
Long-term studies of the features of severe infection and scientific developments in the field of medicine have reduced the incidence of severe Lewis complications , and patients are becoming less and less aware of what these complications of neurosyphilis are. Thanks to preventive diagnostics, which makes it possible to detect the disease at an early stage, and treatment with potent drugs that completely destroy pathogenic microorganisms, it is possible to prevent further damage to internal organs in most patients who have encountered syphilis.
Many scientists believe that one of the reasons for the decrease in the incidence of neurosyphilis is also a decrease in the activity of treponema pale – a bacterium that causes syphilitic lesions in the body.
IMPORTANT! Despite early diagnosis and prevention of complications of the disease, the number of people infected with Lewis continues to increase from year to year.
Stages of development of the disease
The classification of neuroosyphilis includes several stages
- Latent. The first stage, at which the first stage of the pathogenesis of treponema pale occurs: the introduction of a pathogenic microorganism into the cells of the spinal cord and the activation of its vital processes. This is an asymptomatic period, it is possible to detect an infection only by clinical tests, in which the cerebrospinal fluid is examined.
- Early. Development occurs during the first two years after the penetration of the bacterium into the body, coinciding with the stages of primary and secondary syphilis. It is characterized by the destruction of cells lining the vessels and membranes of the brain and spinal cord, therefore, its main manifestations include various forms of diseases from the field of neurology. With strong immunity or under the influence of external factors, an early form of neurosyphilis can develop much later – 4-5 years after infection.
- Late. The average development period is 7-8 years after infection, occurs against the background of tertiary Lewis . At this stage, the cells and fibers of the brain tissues are destroyed directly. Manifested by progressive paralysis, dorsal tabes, visual diagnosis reveals syphilitic gummas in many parts of the brain.
Reasons for development
Treponema pallidum is the causative agent of neurosyphilis and its complications. Their penetration into the body occurs through contact with an infected person, most often during an intimate relationship. The bacterium enters the body through minor damage to the skin or mucous epithelium, enters the bloodstream, and then spreads throughout the body.
As soon as the pest has entered the body, the immune system begins to produce antibodies to destroy it. While the defense system is strong, the activity of treponema is restrained, but as soon as the immune system weakens, it begins to multiply rapidly, affecting various internal organs, incl. spinal cord and brain.
The development of neurosyphilis is due to improper therapy of the primary form of the classical Lewis or its absence, injuries of the craniocerebral box, severe stress, mental fatigue. Also, alcohol abuse, drug use, chronic pathologies, autoimmune diseases (HIV, lupus erythematosus, hepatitis) contribute to a decrease in the strength of immunological protection.
IMPORTANT! Is syphilis contagious? In the first stages of the development of the disease, patients pose the greatest threat to others: infection during the first unprotected sexual contact occurs in more than 90% of cases. Starting from the sixth year of wearing the virus, its contagiousness decreases.
The symptoms of neurosyphilis depend on the stage of the disease and the general health of the person. So, asymptomatic neurosyphilis does not manifest itself in any way, or its signs can be erased, similar to the symptoms of other diseases.
Common signs of asymptomatic pathology include:
- weakness, apathy, fatigue;
- recurrent headaches and dizziness;
- causeless numbness of hands and feet, tingling in them;
- sleep disorders.
The early and late stages of the pathology are manifested by serious complications, each of which has its own series of characteristic symptoms. The most common consequence of neurosyphilis is acute syphilitic meningitis. This disease is characterized by dyspeptic disorders and skin phenomena. The latter include the appearance of papules and damage to the cranial nerves.
The next complication is meningovascular syphilis. Due to damage to large blood vessels of the brain, it can symptomatize with ischemic or hemorrhagic stroke. This manifests itself in the form of dizziness, sudden changes in the psycho-emotional state, a split personality. If the pathology is not treated, dysfunction of the arteries of the spinal cord is possible.
Meningomyelitis of a syphilitic nature is manifested by paraplegia (bilateral damage to motor neurons in the brain), in which muscle tone is lost and serious restrictions on motor activity occur. Also, the patient feels a loss of sensitivity and disruption of the organs of the pelvic region. A feature of the complication is the sharp appearance of unpleasant symptoms.
One of the most common complications is the dorsal tabes. Its signs are similar to the symptoms of sciatica, but the pain is very acute. Often patients complain of the appearance of trophic ulcers of the lower extremities. The sensitivity of the legs also decreases, loss of reflexes is possible.
Progressive paralysis is characterized by impaired memory, thinking, personality disorders. Patients with this complication are characterized by thoughts of murder or suicide, the appearance of hallucinations, delusional states. Muscle tone decreases, which is manifested by tremor of the arms and legs, disruption of the pelvic organs, and seizures of epilepsy.
Signs of syphilitic gums indicate extensive damage to the brain parenchyma and increased intracranial pressure. Outwardly, it is expressed by dysfunction of the lower body: loss of sensitivity, muscle weakness, limitation of mobility.
Diagnostic procedures for neurosyphilis are prescribed in three directions. Their task:
to establish the general clinical picture of the pathology;
- obtain the results of laboratory blood tests, visual examinations of the affected organs;
- detect the pathogen in the cerebrospinal fluid.
Only on the basis of all the examinations performed, the doctor will be able to establish a final and complete diagnosis.
In order for the clinical picture to be complete, several blood tests are carried out at once. These are several common immune tests that determine the presence of treponema pale, its number, the presence of antibodies to it. This allows you to set the duration of the disease and assess the state of immunity.
magnetic resonance imaging) and CT (computed tomography) are the most effective . They allow you to establish the presence of even minor lesions of internal organs and the prerequisites for their rapid development. A less effective method of visual examination is ultrasound (ultrasound diagnostics). It is resorted to if there is no opportunity to conduct more informative examinations.
Some patients may be prescribed a lumbar puncture – an analysis of the cerebrospinal fluid. Confirmation of the diagnosis is the presence of the pathogen and excess protein.
Treatment of neurosyphilis requires constant medical supervision, so the placement of the patient in a hospital is mandatory. The basis of therapy is antibiotics of the penicillin group, which are administered according to an individual scheme at regular intervals. The duration of treatment is different, depending on the severity of the patient’s condition, on average it is about 14 days. As a rule, forecasts are already becoming comforting.
Penicillin is administered intravenously or diffusely. Intramuscular injections do not give the desired result, because. the concentration of the main active substance in the blood is reduced due to its absorption by other cells of the body. With direct contact with the blood, penicillin enters the cerebrospinal fluid in the right amount.
IMPORTANT! In the presence of intolerance to penicillin, the patient is administered drugs from the tetracycline or cephalosporin group.
In the first days of treatment, patients experience a slight deterioration in their condition, exacerbation of neurological manifestations, which disappear after 2-3 days. This phenomenon is due to the mass destruction of the pathogen: their toxic waste products massively penetrate into the blood, which causes symptoms of intoxication:
- severe headaches, migraines;
- high body temperature;
- lowering blood pressure;
- increased heartbeat.
If after a few days the patient’s condition improves, the brightness of the symptoms decreases, and the tests show a decrease in the concentration of treponema pale in the body, then the prescribed therapy is effective. Otherwise, it will need to be corrected. There are several such control checks for the entire course of treatment.
At the end of the course of treatment, the patient is discharged, but over the next 24 months he needs to regularly give screening tests: for example, a study of cerebrospinal fluid is carried out every six months. If all tests are negative, the patient may be removed from the AED. An important stage of recovery is rehabilitation therapy, which is performed by neurologists and psychiatrists.
Consequences of pathology and methods of prevention
Thanks to penicillin, neurosyphilis can be dealt with quickly and effectively. The exception is the presence of dorsal tabes, which is not amenable to this type of therapy. If treatment is started in a timely manner, before the appearance of serious complications, after recovery, the patient returns to his usual way of life.
But significant damage to the spinal cord or brain is not subject to reverse regeneration, so patients face such consequences as paresis of muscle tissue, disruption of brain activity, and asthenia.
Their preventive measures for the development of neurosyphilis can be distinguished by the early diagnosis of Lewis himself . You should regularly undergo preventive examinations, consult a doctor if even minor health problems appear.
The first symptoms of the pathology are similar to the manifestations of banal overwork, they are often attributed to the effects of stress or seasonal viral diseases. Self-medication can lead to the progress of the pathology and the more rapid development of complications, the transition to the next, more severe stage.
It is possible to prevent the penetration of the causative agent of syphilis into the body by observing the purity of sexual life and the rules of personal hygiene. The sex partner must be alone and verified, in case of doubtful sexual contacts, it is necessary to use barrier contraceptives, and after them treat the genitals with antiseptic solutions. It is important to take a shower in the morning and in the evening, change underwear regularly, use only personal toiletries.