Specific Neurosyphilis:The Clinical Characteristics And Management Of Syphilitic Myelopathy

Objective:To study the clinical features,therapy and prognosis of syphilitic myelopathy to improve its diagnosis and treatment.Methods:A retrospective analysis of patients with syphilitic myelopathy,searched in Medline and Chinese Biomedical Literature Database,was performed.Results:Fifty-six studies involving 63 patients(21 cases of spinal meningeal vascular syphilis,33 cases of tabes dorsalis and 9 cases of spinal gumma)were evaluated,the clinical features of them included the follows:male are more common;mainly middle-aged and elderly;acute,subacute or chronic onset,progressive development;numbness and weakness of the lower limbs was commonly the first symptoms;serum examination results of syphilis is all positive;the features of cerebrospinal fluid for cell number and protein content of the vast majority of increased,cerebrospinal fluid examination results of syphilis is not all positive;There are many imaging changes;definite diagnosis was difficult;after anti-syphilitic therapy,symptoms could be improved more or less in a short time;and evidence of long-term prognosis was insufficient.Conclusion:Clinical manifestation,syphilitic related antibody detection in cerebrospinal fluid and serum,biochemistry of cellular biology of cerebrospinal Fluid was the key factors for diagnosis of syphilitic myelopathy.The imaging was an important adjuvant method for diagnosis.The favorable outcome of syphilitic myelopathy could be obtained by diagnosis and treatment at early stage.