How is neurosyphilis differentiated from schizophrenia?

Updated: Mar 16, 2018
  • Author: Frances R Frankenburg, MD; Chief Editor: Glen L Xiong, MD  more...
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Answer

Neurosyphilis can be divided into the following 3 categories:

  • Meningovascular syphilis

  • Tabes dorsalis

  • General paresis

Patients with general paresis may present with behavioral changes, psychosis or dementia. The diagnosis can be suggested by a history of exposure, personality changes, and pupillary changes (Argyll Robertson pupil).

The Venereal Disease Research Laboratory (VDRL) and rapid plasma reagin (RPR) tests are nontreponemal tests that use antigens to detect antibodies to Treponema pallidum. Because antibodies decline during the disease, these tests have a high false-negative rate. If neurosyphilis is strongly suspected, more specific treponemal tests, such as the fluorescent-treponemal antibody absorption test (FTA-ABS), can be useful.


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