Neurosífilis como causa de demencia en el anciano. Una enfermedad a tener presente

Abstract

General paresis (GP) and tabes dorsalis constitute the clinical spectrum of parenchymatous neurosyphilis. GP presents most frequently as disorder of personality and behaviour together with cognitive impairment. This disease, which used to be so common in the past, is now a rare cause of dementia. Herein we present the cases of two elderly patients, a 78 year-old man and a 72 year-old woman, who were diagnosed of suffering GP after being studied for recent-onset dementia and abnormal behaviour. Serologic tests for syphilis were positives in both cases. CSF examination revealed hyperproteinorakia and a positive test for syphilis in the first case, while only lymphocytic pleocytosis was observed in the second one. Both patients were treated with intravenous aqqueous penicillin G, without improvement in their neuropsychological status. Parenchymatous neurosyphilis is a very uncommon disease nowadays. However, the expansion of the AIDS epidemics and certain cultural and demographics changes have triggered an increase in its incidence. In our opinion, this disease should be borne in mind when approaching the initial work-up of a new-onset dementia.