Paretic Neurosyphilis - General Paresis

General paresis is a chronic infection of the brain with Treponema pallidum, the organism that causes Treponema pallidum\ bacteria. Less often, syphilis is transmitted from a pregnant woman to her baby. This form of syphilis is known as \congenital syphilis.\ ',CAPTION,'Syphilis');" onmouseout="return nd();">syphilis. It is a tertiary, or third-stage, form of syphilis that affects the brain and spinal cord.

What is going on in the body?

General paresis is a tertiary form of syphilis. It develops in 5% of the people with untreated syphilis when Treponema pallidum attacks the nervous system. It causes a gradual mental and neurological decline. The symptoms generally appear 20 years or more after the initial infection.

What are the causes and risks of the disease?

General paresis is a long-term effect of an untreated Treponema pallidum\ bacteria. Less often, syphilis is transmitted from a pregnant woman to her baby. This form of syphilis is known as \congenital syphilis.\ ',CAPTION,'Syphilis');" onmouseout="return nd();">syphilis infection.

What are the signs and symptoms of the disease?

Following are some of the symptoms of general paresis:

How is the disease diagnosed?

Diagnosis of general paresis begins with a medical history and physical exam. Samples of blood and cerebrospinal fluid can be examined for signs of the infection. Cerebrospinal fluid is the liquid that surrounds the brain and spinal cord.

What can be done to prevent the disease?

If Treponema pallidum\ bacteria. Less often, syphilis is transmitted from a pregnant woman to her baby. This form of syphilis is known as \congenital syphilis.\ ',CAPTION,'Syphilis');" onmouseout="return nd();">syphilis is recognized early in its course, it can be cured with antibiotics. General paresis develops only in those who go for years without treatment. Preventive strategies also include the following:

What are the long-term effects of the disease?

Some of the changes of general paresis are not reversible. The brain itself often becomes damaged. Treatment is important to stop the brain damage at the earliest possible time. Dementia from any cause increases the risk of early death. It also makes a person less able to carry out normal daily activities.

What are the risks to others?

General paresis occurs after many years of a syphilis infection, when the person is no longer contagious.

What are the treatments for the disease?

General paresis is treated with high doses of penicillin for two or more weeks. Treatment early in the course of general paresis improves the mental and physical symptoms in about 40% of people.

What are the side effects of the treatments?

Penicillin may cause allergic reactions, rash, or stomach upset.

What happens after treatment for the disease?

Treatment halts the progression of the disease 40% to 50% of the time. Neurological problems improve in 30% to 40% of cases. The cerebrospinal fluid has to be rechecked to be sure that the Treponema organism is completely eliminated. Sometimes, the penicillin treatment has to be repeated. Any new or worsening symptoms should be reported to the healthcare provider.

Author:Gerald C. McIntosh, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:05/31/01
Reviewer:Barbara Mallari, RN, BSN, PHN
Date Reviewed:05/07/01