Session Time: 1:45pm-3:15pm
Location: Les Muses Terrace, Level 3
Objective: To report the cases of neurosyphilis revealed by the association parkinsonism and psychotic symptom.
Background: The NS is the “great imitator” because it can imitate many types of medical conditions. Most manifestations of NS are potentially reversible. In front the association of psychotic symptoms and parkinsonism we must think about neurosyphilis.
Method: Authors analyzed retrospectively observations of neurosyphilitic, collected in the neurology department of the Mohammed VI hospital in Marrakech (Morocco) over a period of 18 years (between 2000 and 2018) ;Diagnostic criteria was based on positive syphilis serology (TPHA, VDRL) in the blood and in the CSF with the presence of psychotic symptom and parkinsonism.
Results: 10 patients of all patients with NS in this period (94 patients) had psychotic symptoms and parkinsonism (10,6%).The 10 patients was males; their Mean age was 43 years (range 33 to 60 years).Sexual risk behaviors were found at 63% of patients; Syphilitic chancre had been noticed in 38 % of patients; none of the patients had a family history of psychiatric disorders in their first degree relatives, the mean latency between onset of symptoms and consultation was 19 months. In 2 patients the parkinsonism revealed the neurosyphilis and in 8 patients the neurosyphilis was revealed by psychotic symptoms. Minimental state of Folstein was performed in all patients; it varied from 4/24 to 26/30. Diagnosis was established with positive TPHA (Treponema Pallidum Hemagglutinations Assay) and VDRL (Venereal Disease Research Laboratory) in cerebrospinal fluid (CSF). Both CT (Computed tomography) scan and cerebral MRI (Magnetic resonance imaging) showed in the majority a cortical atrophy. Treatment was based on aqueous sodium Penicillin G, with cures of 30 Million units per day repeated 4 times each three months. After a mean follow-up of 2 years, symptoms improved in 8, in 2 patients symptoms were stabilized.
Conclusion: The combination of parkinsonism and psychotic symptoms should push us to do test for syphilis. Treatment with anti-syphilis may be effective, especially in early stage.
To cite this abstract in AMA style:S. Nafia, N. Louhab, M. Chraa, N. Kissani. The association parkinsonism and psychotic symptom in neurosyphilis [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/the-association-parkinsonism-and-psychotic-symptom-in-neurosyphilis/. Accessed December 5, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-association-parkinsonism-and-psychotic-symptom-in-neurosyphilis/