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J Korean Neurol Assoc. 1985;3(1):29-39.
- NEUROSYPHILIS-A STUDY OF 85 CASES
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Jin-Sang Jung, M.D., Jae-Kyue No, M.D., Ho-Jin Myung, M.D.
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Department of Neurology, Seoul National University
- 신경매독-85예에 대한 고찰-
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정진상, 노재규,명호진
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서울대학교 신경과.
- Abstract
- 85 cases of neurosyphilis were observed in Seoul National University Hospital over 6-year period (1979-1984). They were analyzed with respect to clinical symptoms and signs in individual types, serological data in both blood and CSF, changes of cytochemical compositions in CSF, and other significant findings. And some coparisons with other reports were made.
They ranged from 22 to 66 years in age with the peak incidence in the forties (41%).
Ratio of male to female was observed to be 4.3:1.
There were 27 cases of asymptomatic neurosyphilis (NS) (32%), 14 cases of tabes
dorsalis (16%), 18 cases of general paresis (21%), 2 cases of taboparesis (2%), 7cases of
vascular NS (8%), 6 cases of meningeal NS (7%), 4 cases of syphilitic eight nerve
involvement (5%), 4 cases of late syphilitic ocular involvement including optic atrophy (5%),
and 3 cases of spinal form (4%). Except in 4 self-referral cases, alimentary system symptoms
or illnesses were the main prolbems in asymptomatic neurosyphilitics (48%). Most
symptomatic cases had the similar clinical pictures as described in the previous reports but
some cases appeared to be combined with symptoms and signs of different types. In tabes
dorsalis, patients presented paresthesia and hypoactive DTRs in lower limbs as the most
frequent features. According to predominant manifestations, there were 4 cases of dementic
form and 14 cases of psychotic form in general paresis but in most cases both features
overlapped each other. In 8 cases of general paresis brain CT scans were performed, which
revealed diffuse cerebral atrophy in five. Focal abnormalities of vascular NS were most
frequently found in temporal areas (4 in 7 cases). Meningeal irritation signs were observed
only in one among 6 cases 6 meningeal NS. All cases of eighth nerve involvement showed
sensorineural hearing loss at high-tone level.
Compared with TPHA, which was used as a criterion for the patient selection, VDRL
reactivity was 98% in serum and 49% in CSF. It is notable that as for general paresis and
meningeal NS, higher reactivity and elevated titers of CSF VDRL were associated with
increase of cells and total protein in CSF, suggesting higher disease activity in both types.
Unlike those from other countries, the domestic studies including this report show that
general paresis occupies a relatively higher proportion than tabes dorsalis in Korea.
Keywords :
- 초록
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