Neurosyphilis differential diagnosis

Revision as of 17:22, 5 March 2018 by M Jahan (talk | contribs)
Jump to navigation Jump to search

Neurosyphilis Microchapters

Home

Patient Information

Overview

Historical perspective

Classification

Pathophysiology

Causes

Differentiating Neurosyphilis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Neurosyphilis differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Neurosyphilis differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Neurosyphilis differential diagnosis

CDC on Neurosyphilis differential diagnosis

Neurosyphilis differential diagnosis in the news

Blogs on Neurosyphilis differential diagnosis

Directions to Hospitals Treating Neurosyphilis

Risk calculators and risk factors for Neurosyphilis differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]Tarek Nafee, M.D. [3]

Overview

Neurosyphilis must be differentiated from other diseases that cause abnormal gait, Blindness, confusion and depression, such as multiple sclerosis, Brain tumours, Wernicke’s encephalopathy, CNS abscess, electrolyte disturbance, Subdural empyema, subarachnoid hemorrhage, brain stroke, Conversion disorder and Drug toxicity.

Differentiating X from other Diseases

  • Neuroyphilis has an extensive differential diagnosis.
Diseases Diagnostic tests Physical Examination Symptoms Past medical history Other Findings
Na+, K+, Ca2+ CT /MRI CSF Findings Gold standard test Neck stiffness Motor or Sensory deficit Papilledema Bulging fontanelle Cranial nerves Headache Fever Altered mental status
Neurosyphilis[3][4] Leukocytes and protein
  • CSF FTA-Ab -sensitive[5]
  • Unprotected sexual intercourse, STIs
  • History of multiple sexual partners.
Multiple sclerosis Oligoclonal bands of IgG on electrophoresis of cerebrospinal fluid MRI
Brain tumour[1][2] Cancer cells[7] MRI
  • Cachexia
  • Gradual progression of symptoms
Wernicke’s encephalopathy Normal History of alcohal abuse
CNS abscess
  • Contrast enhanced MRI is more sensitive and specific
Electrolyte disturbance or Depends on the cause
Subdural empyema Clinical assesment and MRI History of relapses and remissions
  • Blurry vision
Delirium tremens Clinical diagnosis
  • Alcohol intake
  • Sudden withdraw or reduction in consumption
Subarachnoid hemorrhage[8] Xanthochromia[9] CT scan without contrast[11][6] Trauma/fall
Stroke Normal CT scan without contrast TIAs, hypertension, diabetes mellitus
  • Speech difficulty
  • Gait abnormality
Viral encephalitis Clinical assesment
  • Tick bite
  • Mosquito bite
  • Viral prodome for several days
Extreme lethargy, rash hepatosplenomegaly, lymphadenopathy, behavioural changes
Herpes simplex encephalitis Clinical assesment History of hypertension
Drug toxicity
Conversion disorder Diagnosis of exclusion
Febrile convulsion Not performed in first simple febrile seizures Clinical diagnosis and EEG
  • Family history of viral illness or
Age > 1 month,
Hypoglycemia ↓ or Serum glucose

HbA1c

History of diabetes

References

  1. 1.0 1.1 Soffer D (1976) Brain tumors simulating purulent meningitis. Eur Neurol 14 (3):192-7. PMID: 1278192
  2. 2.0 2.1
  3. 3.0 3.1 Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG; et al. (2012). "Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients". J Neurol Sci. 317 (1–2): 35–9. doi:10.1016/j.jns.2012.03.003. PMID 22482824.
  4. 4.0 4.1 Berger JR, Dean D (2014). "Neurosyphilis". Handb Clin Neurol. 121: 1461–72. doi:10.1016/B978-0-7020-4088-7.00098-5. PMID 24365430.
  5. 5.0 5.1 Ho EL, Marra CM (2012). "Treponemal tests for neurosyphilis--less accurate than what we thought?". Sex Transm Dis. 39 (4): 298–9. doi:10.1097/OLQ.0b013e31824ee574. PMC 3746559. PMID 22421697.
  6. 6.0 6.1 DeLaPaz RL, Wippold FJ, Cornelius RS, Amin-Hanjani S, Angtuaco EJ, Broderick DF; et al. (2011). "ACR Appropriateness Criteria® on cerebrovascular disease". J Am Coll Radiol. 8 (8): 532–8. doi:10.1016/j.jacr.2011.05.010. PMID 21807345.
  7. 7.0 7.1 Weston CL, Glantz MJ, Connor JR (2011). "Detection of cancer cells in the cerebrospinal fluid: current methods and future directions". Fluids Barriers CNS. 8 (1): 14. doi:10.1186/2045-8118-8-14. PMC 3059292. PMID 21371327.
  8. 8.0 8.1 Yeh ST, Lee WJ, Lin HJ, Chen CY, Te AL, Lin HJ (2003) Nonaneurysmal subarachnoid hemorrhage secondary to tuberculous meningitis: report of two cases. J Emerg Med 25 (3):265-70. PMID: 14585453
  9. 9.0 9.1 Lee MC, Heaney LM, Jacobson RL, Klassen AC (1975). "Cerebrospinal fluid in cerebral hemorrhage and infarction". Stroke. 6 (6): 638–41. PMID 1198628.
  10. Goldenberg MM (2012). "Multiple sclerosis review". P T. 37 (3): 175–84. PMC 3351877. PMID 22605909.
  11. Birenbaum D, Bancroft LW, Felsberg GJ (2011). "Imaging in acute stroke". West J Emerg Med. 12 (1): 67–76. PMC 3088377. PMID 21694755.

Template:WH Template:WS