Demência por neurossífilis: evolução clínica e neuropsicológica de um paciente

Vargas, Antônio Pedro; Carod-Artal, Francisco Javier; Negro, Maria Cristina Del; Rodrigues, Maira Pinto Cauchioli

doi:10.1590/s0004-282x2000000300029

Cited by 15 publications

(10 citation statements)

References 14 publications

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“…For instance, Fujimoto et al [6] reported a case who presented with immediate, recent and remote memory disturbances. This was consistent with previously reported cases [7,8,9,10,11]. Unfortunately, these studies lacked systematic neuropsychological examinations, and they did not include other dementia patient groups (e.g.…”

Section: Introductionsupporting

confidence: 91%

Cognitive Impairment in Mild General Paresis of the Insane: AD-Like Pattern

Wang¹,

Guo²,

Zhou

et al. 2011

Dement Geriatr Cogn Disord

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Background/Aims: We investigated the clinical and cognitive features of patients with mild general paresis of the insane (GPI) in comparison to Alzheimer’s disease (AD) patients, mild frontotemporal dementia (FTD) patients and normal elderly individuals. Methods: Twelve patients with mild GPI, 24 patients with mild AD, 11 patients with mild FTD and 36 healthy subjects participated in the current study. A comprehensive neuropsychological battery was used to assess memory, language, attention, executive function, visuospatial ability, etc. In addition, cranial MRI were also obtained from the 3 patient groups. Results: Mild GPI showed a similar pattern of cognitive impairments in memory, language and executive function to mild AD, but a mixed pattern of dissimilarities to mild FTD. Mild GPI patients had more complaints and positive signs in the nervous system than mild AD patients, and cranial MRI results showed that mild GPI patients usually had atrophy of the medial temporal lobe. Conclusion: There is an overall decline in cognitive functions of mild GPI patients, which is comparable to that in AD patients, suggesting that there is a wide range of structural changes in the brains of mild GPI patients as well. However, further studies are needed to verify whether these structural changes are similar to those in AD.

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Section: Introductionsupporting

confidence: 91%

Cognitive Impairment in Mild General Paresis of the Insane: AD-Like Pattern

Wang¹,

Guo²,

Zhou

et al. 2011

Dement Geriatr Cogn Disord

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“…However, mild cognitive impairment could be observed in early stages of neurosyphilis [2]. It should be noted that before his most celebrated discovery, Alois Alzheimer had dedicated several years of his life to the study of the neuropathology of syphilis, which was the theme of his post-doctoral thesis (Habilitationsschrift) [3].…”

Section: Introductionmentioning

confidence: 99%

Neurosyphilis presenting with dementia, chronic chorioretinitis and adverse reactions to treatment: a case report

Mehrabian¹,

Raycheva²,

Petrova³

et al. 2009

Cases J

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Neurosyphilis results from infection of the brain, meninges or spinal cord by Treponema pallidum and develops in about 25%-40% of persons who are not treated for syphilis. This article reports a rare case of active neurosyphilis with mild dementia, chronic chorioretinitis, and hearing loss. During the treatment with Penicillin, a rare combination of complications such as Jarisch-Herxheimer and Hoigné reactions were observed.The clinical feature is characterized by a slow progressive cognitive decline and behavior changes for the last 2 years. Neuropsychological examination revealed mild dementia (MMSE = 23) with impaired memory and attention and executive function. Left sided chronic chorioretinitis and hearing loss were documented. High dose intravenous penicillin therapy was complicated by Jarisch-Herxheimer and Hoigne reactions. During the follow up examinations at 6 and 12 months, the clinical signs, neuropsychological examination, and cerebrospinal fluid (CFS) samples showed improvement of dementia, CSF findings, and hydrocephalus.In conclusion, this atypical presentation of neurosyphilis in combination with rare complications of treatment is worthy of attention. Neurosyphilis should be part of the differential diagnosis of each patient showing cognitive deterioration and behaviour disturbances.

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“…Case reports scattered throughout the medical literature suggest that several different infectious agents can drive dementia development. Rapidly progressive dementia (RPD) can be caused by enterovirus [60], HIV-associated neurocognitive disorders (HAND) bear similarities to AD [61], neuroborreliosis can cause secondary dementia [62], and it is well accepted that syphilis (Treponema pallidum) can cause dementia that abates with timely intravenous (IV) antibiotic treatment [63]. Moreover, end-stage syphilis resulting in general paresis is histopathologically indistinguishable from AD [64].…”

Section: Dementias Caused By Infectious Agentsmentioning

confidence: 99%

“…In addition, cognitive impairment may abate with proper antiinfective treatment such as in cases of HIV [65], syphilis before the development of general paresis [66], and Lyme neuroborreliosis [62]. Vargas et al [63] remark that 'Neurosyphilis should be a part of the differential diagnosis of every patient showing cognitive deterioration and behavior disturbances', a sentiment supported by other clinicians [67]. The parasitic infection cysticercosis caused by larvae of Taenia solium is known to cause dementia in developing countries, and timely initiation of proper treatment results in favorable neurologic outcomes -'reversible dementia' [68,69].…”

Section: Dementias Caused By Infectious Agentsmentioning

confidence: 99%

Establishment of a consensus protocol to explore the brain pathobiome in patients with mild cognitive impairment and Alzheimer's disease: Research outline and call for collaboration

Lathe

Schultek*²,

Balin

et al. 2023

Preprint

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Microbial infections of the brain can lead to dementia, and for many decades microbial infections have been implicated in Alzheimer's disease (AD) pathology. However, a causal role for infection in AD remains contentious, and the lack of standardized detection methodologies has led to inconsistent detection/identification of microbes in AD brains. There is a need for a consensus methodology; the Alzheimer's Pathobiome Initiative aims to perform comparative molecular analyses of microbes in post-mortem brain versus cerebrospinal fluid (CSF), blood, olfactory neuroepithelium, oral/nasopharyngeal tissue, bronchoalveolar, urinary, and gut/stool samples. Diverse extraction methodologies, PCR and sequencing techniques, and bioinformatic tools will be evaluated, in addition to direct microbial culture and metabolomic techniques. The goal is to provide a roadmap for detecting infectious agents in patients with mild cognitive impairment or AD. Positive findings would then prompt tailoring of antimicrobial treatments that might attenuate or remit mounting clinical deficits in a subset of patients.

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Demência por neurossífilis: evolução clínica e neuropsicológica de um paciente

Cited by 15 publications

References 14 publications

Cognitive Impairment in Mild General Paresis of the Insane: AD-Like Pattern

Cognitive Impairment in Mild General Paresis of the Insane: AD-Like Pattern

Neurosyphilis presenting with dementia, chronic chorioretinitis and adverse reactions to treatment: a case report

Establishment of a consensus protocol to explore the brain pathobiome in patients with mild cognitive impairment and Alzheimer's disease: Research outline and call for collaboration

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