The Clinical Presentation and Imaging Manifestation of Psychosis and Dementia in General Paresis: A Retrospective Study of 116 Cases

• Published in: The journal of neuropsychiatry and clinical neurosciences 2011-07, Vol.23 (3), p.300-307
• Main Authors: Zheng, Dong, Zhou, Daoyou, Zhao, Zhongyan, Liu, Zhonglin, Xiao, Songhua, Xing, Yigang, Suo, William Z, Liu, Jun
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Bacterial diseases; Bacterial diseases of the genital system; Bacterial diseases of the nervous system. Bacterial myositis; Biological and medical sciences; Dementia - epidemiology; Dementia - etiology; Dementia - pathology; Electroencephalography; Epidemiology. Vaccinations; Female; General aspects; Human bacterial diseases; Humans; Infectious diseases; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Miscellaneous; Morbidity; Neurosyphilis - cerebrospinal fluid; Neurosyphilis - complications; Neurosyphilis - epidemiology; Occupations; Psychosis; Psychotic Disorders - epidemiology; Psychotic Disorders - etiology; Psychotic Disorders - pathology; Retrospective Studies; Sex Factors; Sexually Transmitted Diseases - epidemiology; Tomography, X-Ray Computed; Treponema pallidum
• ISSN: 0895-0172; 1545-7222
• DOI: 10.1176/jnp.23.3.jnp300

In recent years, occurrence of “general paresis (GP)” has increased significantly because of the increasing incidence of syphilis in China. Early diagnosis plays a very important role for effective treatment. Incidence is becoming extensive enough to warrant an updated investigation of the clinical characteristics of GP. The authors retrospectively reviewed 116 cases of GP in Guangzhou, China, and analyzed its incidence and clinical appearance, as well as the characteristics of EEG, neuroradiology, serum, and cerebrospinal fluid examinations. Of the 116 GP patients, clinical symptoms presented frequently on admission were a variety of psychiatric-behavioral symptoms and varying degrees of dementia. Positive sucking reflex was the most common sign, as well as hyperreflexia and Argyll-Robertson pupil. EEG data mainly showed slightly abnormal EEG activity, with increased δ waves. Focal atrophy in one or multiple cerebral regions was evident on neuroimage. The prevalence of GP extends to various social strata or classes, with clinical presentation varying considerably among patients. For patients with progressive cognitive and behavioral deterioration, accompanied with psychotic and/or affective behavioral disorders or cerebral atrophy of unknown cause, general paresis should be considered.