【摘要】 目的分析9例神经梅毒的临床、神经影像学、实验室检查和临床诊治情况。方法回顾性分析9例神经梅毒患者的临床症状、神经影像学和实验室检查特点。结果 9例血清和脑脊液梅毒学试验均阳性,影像学多表现为单个或多发的脑梗死病灶,位于额叶、颞叶、脑室周围等,可以肢体麻木、偏瘫等症状就诊,首诊常被误诊为脑卒中、老年性痴呆、颅内肿瘤等。结论神经梅毒的临床表现与其分型密切相关;首诊易误诊;临床表现及血和脑脊液梅毒抗体阳性是确诊的依据,影像学表现不具特征性,早期治疗效果较好,青霉素为首选药物。更多还原

【Abstract】 Objective To analyze the clinical features,neuroimaging,laboratory findings and misdiagnosis of neurosyphilis.Methods Clinical features,neuro-images and laboratory findings of 9 neurosyphilis patients were analyzed retrospectively.Results There were 6 male and 3 female in these 9 patients,the tests of serum and cerebrospinal fluid showed positive antibody reaction to Treponema pallidum.CT/MRI findings of brain revealed single or multiple asymmetrical lesions,involving frontal lobe,emporal lobe,periventricular and so on.The patients may visit with syndrome of anesthesia,hemiparalysis and so on.After first diagnosis all cases were misdiagnosed as stroke,intracranial tumor,meningitis Alzheimer disease and so on.Conclusion Patients with neurosyphilis could present diverse clinical symptoms at the beginning of the course and be divided to different clinical types accordingly,therefore it is misdiagnosed easily at first diagnosis.More importantly positive syphilis antibody in serum or CSF is specific for diagnosis.Penicillin is the first choice for the effective treatment.更多还原