神经梅毒13例临床分析并文献复习

目的：探讨神经梅毒诊断要点,提高临床医生对该病的认识,降低误诊和漏诊率.方法：回顾性分析13例神经梅毒患者的临床资料特点,结合文献分析其临床表现、分型及诊断要点.结果：13例中无症状神经梅毒3例,脑（脊）膜血管梅毒5例,脊髓痨2例,麻痹性痴呆3例,其中4例误诊.常见症状有精神行为异常、癫痫发作及多发性脑梗死症状.影像学表现为脑萎缩、脑积水、脑梗死及大脑中动脉狭窄或闭塞.结论：神经梅毒临床表现复杂多变,无特异性,误诊和漏诊率高,影像学检查对诊断有提示作用.

Clinical analysis of 13 cases of neurosyphilis and review of the literature

Objective：To discuss the diagnostic criteria of neurosyphilis and decrease the misdiagnosis and missed diagnosis of the disease. Methods ：The clinical data of 13 cases of neurosyphilis were presented, and the clinical manifestation, typing and diagnostic criteria of the disease were analyzed by review of the literature. Results：Among the 13 cases of neurosyphilis,3 cases had asymptomatic neurosyphilis,5 meningovascular syphilis, 2 tabes dorsalis and 3 paralytic dementia;4 of the cases were misdiagnosed. The common symptoms included mental and behavioral abnormalities, epileptic seizure and multiple cerebral infarctions. The imageology manifestation showed brain atrophy, hydrocephalus, multiple cerebral infarction and middle cerebral artery stenosis or occlusion. Conclusions：The clinical manifestations of neurosyphilis are varied and lack of specificity; it is easy to be misdiagnosed or misdiagnosed. Abnormal imageology would be of help to the diagnosis of the disease.