neurosyphilis - a disease of the nervous system that occurs when the bacterium infecting her Treponema pallidum, pale treponema. Divided into early and late neurosyphilis, treatment of which should not be delayed. The disease can begin at any time in the flow of syphilis is more common in secondary or tertiary.
Overview
Until a few decades ago neurosyphilis occurs quite frequently. At present, due to improvements in treatment, the development of effective drugs and diagnostics of neurosyphilis is rarer. But the mechanisms of CNS, Treponema pallidum interaction with cells of the immune system have not been studied thoroughly and still. A use of some drugs can lead to the conversion of active bacteria in inactive form - cysts, L-shaped, spores, grain.
Causes
The only cause of neurosyphilis - infection of Treponema pallidum. It may be present in blood, semen, vaginal secretions, saliva of a sick person. Also sexual pathway (via the microdamages on mucous and skin), distinguish such methods getting infections:
- blood transfusion, Ie infection by blood transfusion or preparations using a common syringe addicts or narcotic substance container;
- medical manipulations - dental procedures, childbirth, surgery, examination, fence material for analysis; can catch the patient and the medical officer;
- transplacental - from an infected mother to the placenta;
- domestic - the likelihood of infection is less, but use common towels, razors, toothbrushes, tableware items it is saved; Kiss also refer to the risk factors.
Classification
To distinguish itself syphilis primary, secondary and tertiary stage. Neurosyphilis may arise and accompany each of them.
distinguished:
- The early neurosyphilis. So we call a disease developed in the first five years after infection with Treponema pallidum. Most often it occurs in the first year or two. Infestation mesenchymal apparatus nervous system - the blood vessels, and perineurium endoneurium (connecting sheath around the nerve fiber bundles). Therefore, early neurosyphilis still is called "mesenchymal".
- late neurosyphilis. From the moment of infection to the development of his passes for five years or more. Another is called "parenchymal" as mesenchyme loses ability to inhibit bacteria, and they reach the parenchyma, ie directly to the nerve cells and fibers.
- congenital neurosyphilis. It manifests itself in the first year of a child's life, infected with syphilis in utero.
Symptoms early stage
Symptomatology of neurosyphilis rich and depends on the localization of the pathogen, the degree of damage and the age of the patient.
At an early stage specific symptoms may be absent altogether. Identification of the disease at this time is random and is due to the research of spinal cord fluid.
One of the most common forms - syphilitic meningitis - manifested by headaches, nausea, vomiting (after which there is no relief as in case of poisoning).
The physician may focus on the so-called meningeal signs of neurosyphilis - a stiff neck (ie limiting the head turns to the side, forward), symptom Kernig, Brudzinskogo. With appropriate examination revealed hydrocephalus (Edema), increased intracranial pressure.
Depending on which nerves are struck, the symptoms will vary. If the eye - deteriorating eyesight, Oculomotor - developing strabismus, Hearing - arises hearing loss.
If neurosyphilis defeat of more concern to the vessel, as the sensitivity of the violation, memory impairment, Reduced ability to concentrate, speech disorders. Patients complain of dizziness and headaches, changes in behavior and sleep impairment. Sometimes there are seizures, the weakening of the hands and feet of strength. When infection is extensive, may occur stroke, Ischemic or hemorrhagic.
When spinal infection occurs spinal stroke - increasing weakness in the legs, loss of control over urination, defecation, and loss of sensation below the affected area.
The symptoms of late stage
The destruction, in fact, the nerve cells has an effect when:
- deteriorating attention, memory;
- It appears (or amplified) irritability;
- behavior becomes inadequate;
- hallucinations occur;
- handwriting varies.
Another characteristic feature - a syndrome A. Robertson. When you save the accommodation and convergence of the pupils do not respond adequately to the light.
With develop paralysis, seizures over time, broken functionality pelvis.
symptoms of congenital
In young children, the disease manifests itself in three symptoms Hutchinson: keratitis - inflammation of the cornea, deafness, and deformation characteristic of the teeth - of the recess and the edge of the barrel-shaped. often manifests hydrocephalus.
Diagnostics
For the purpose of setting the proper, timely diagnosis is required to complete the survey.
The survey should include:
- a thorough examination of neurologist;
- Laboratory tests of blood, cerebrospinal fluid;
- computed tomography;
- MRIs.
High diagnostic value of specific treponemal tests. IFA - immunofluorescence and RIBT (RHS) - reaction to immobilize treponemes.
Treatment
Treponema may seem outdated and "unsuitable" to modern life - in most cases it still responds to penicillin. This weak, in our opinion, antibiotic-resistant bacteria do not develop an effective defense. Doses neurosyphilis, the method multiplicity of drug administration, as well as their duration should be determined only by experts in the hospital.
If you are hypersensitive to penicillin antibiotics is assigned a number of other antimicrobial agent. Mandatory requirement - the drug must penetrate the blood-brain barrier.
In addition to antibiotics in neurosyphilis prescribed drugs:
- anti-inflammatory;
- vascular;
- vitamin;
- neyrometabolicheskie.
prevention
Preventing "neurosyphilis" of the disease can include two large groups of preventive measures:
- the general thrust of the action;
- preventing injury to the nervous system in detecting disease.
In the first case we are talking about hygienically, The sexual culture of life, a planned examination of pregnant women, newborns. In the second - close observation by specialists, timely and complete treatment.
Forecast
Neurosyphilis in the early stages amenable to almost complete recovery. If treponema managed to significantly damage the blood vessels and nerves, the symptoms accompanying the disease may in some degree stay with a person for life.
Congenital syphilis also leaves traces in the child's life-long body. Often deafness or hydrocephalus lead to disability.
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