Article Text

Download PDFPDF
  1. John McAuley,
  2. Gaenor Hughes
  1. Queens Hospital, Romford


Neurosyphilis continues to have a significant incidence in the 21st century, especially in certain subpopulations. It has previously been reported that extrapyramidal features may accompany the more typical central neurosyphilitic manifestions of dementia, ataxia, psychosis, frontal deficits and Argyll-Robertson pupils. We report for the first time neurosyphilis presenting with relatively pure Parkinsonian clinical features.

A 53 year old man with gradual onset of bradykinesia and rigidity was found to have positive Treponemal serology and cerebrospinal fluid VRDL reaction. A major improvement followed antibiotic treatment but, over the subsequent fifteen years, the patient slowly deteriorated again in a manner consistent with idiopathic Parkinson's disease. A dopaminergic deficit was demonstrated on [1 2 3I]FP-CIT SPECT. This late second deterioration could indicate that the neurosyphilitic basal ganglial insult primed or accelerated development of idiopathic-like disease.

Blood test screening for syphilis is not routinely performed in patients presenting with Parkinsonism and so the true prevalence of neurosyphilitic aetiology is unknown. Given the options for treatment, such screening could be justified.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.