Dementia paralytica in a fifteen-year-old boy

A 15-year-old boy, whose history revealed an unremarkable pregnancy, birth and neonatal period and who had shown a normal motor and mental development, presented at the hospital with deterioration of cognitive functions since the age of 7. He was bedridden with manifest ataxia involving all limbs, a...

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Published inJournal of the neurological sciences Vol. 144; no. 1-2; pp. 214 - 217
Main Authors GOEMAN, J, HOKSBERGEN, I, PICKUT, B. A, DOM, L, CROLS, R, DE DEYN, P. P
Format Journal Article
LanguageEnglish
Published Shannon Elsevier Science 01.12.1996
Subjects
Adolescent
Bacterial diseases
Biological and medical sciences
Cognition Disorders - diagnosis
Human bacterial diseases
Humans
Infectious diseases
Male
Medical sciences
Miscellaneous
Neurosyphilis - congenital
Neurosyphilis - diagnosis
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed
Human
Nervous system diseases
Cognitive disorder
Male
Neurosyphilis
Treponematosis
Infection
Case study
Syphilis
Central nervous system disease
Adolescent
Bacteriosis
Diagnosis
Spirachaetosis
Dementia
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Summary:A 15-year-old boy, whose history revealed an unremarkable pregnancy, birth and neonatal period and who had shown a normal motor and mental development, presented at the hospital with deterioration of cognitive functions since the age of 7. He was bedridden with manifest ataxia involving all limbs, anisocoria and a sluggish to absent pupil reaction to light. Syphilis serology was positive with a Venereal Disease Research Laboratory (VDRL) titer of 1:256 and a Treponema pallidum Haemagglutination Assay (TPHA) titer of 1:163840. Cerebrospinal fluid (CSF) protein concentration was 55 mg/dl and CSF-leucocyte count was 14/mm3 (85% mononuclear cells). CSF-VDRL-titer was 1:16. A diagnosis of congenitally acquired dementia paralytica was made, since the boy's parents' clinical exam and serology results were suggestive for latent syphilis. Although cognition was still very much deteriorated five months following penicillin treatment, clinical examination revealed partial recuperation. Screening for syphilis should be part of routine testing in every subject presenting with cognitive deterioration, regardless of age.
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ISSN:0022-510X
1878-5883
DOI:10.1016/S0022-510X(96)00213-4