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Neurosyphilis is an infection that affects the coverings of the brain, the brain itself, or the spinal cord. It can occur in people with syphilis, especially if their condition is left untreated. Neurosyphilis is different from syphilis. Syphilis is a sexually transmitted disease (STD) with different signs and symptoms. There are five types of neurosyphilis:

  1. Asymptomatic neurosyphilis means that neurosyphilis is present, but the individual reports no symptoms and does not feel sick.
  2. Meningeal syphilis can occur between the first few weeks to the first few years of getting syphilis. Individuals with meningeal syphilis can have headache, stiff neck, nausea, and vomiting. Sometimes there can also be loss of vision or hearing.
  3. Meningovascular syphilis causes the same symptoms as meningeal syphilis but affected individuals also have strokes. This form of neurosyphilis can occur within the first few months to several years after infection.
  4. General paresis can occur between three to 30 years after getting syphilis. People with general paresis can have personality or mood changes.
  5. Tabes dorsalis is characterized by pains in the limbs or abdomen, failure of muscle coordination, and bladder disturbances. Other signs include vision loss, loss of reflexes and loss of sense of vibration, poor gait, and impaired balance. Tabes dorsalis can occur anywhere from five to 50 years after initial syphilis infection.

General paresis and tabes dorsalis are now less common than the other forms of neurosyphilis because of advances made in prevention, screening, and treatment. People with HIV/AIDS are at higher risk of having neurosyphilis.

Penicillin, an antibiotic, is used to treat syphilis. Some medical professionals recommend another antibiotic called ceftriaxone for neurosyphilis treatment. Treatment outcomes are different for every person.

Prognosis can change based on the type of neurosyphilis and how early the disease is diagnosed and treated. Individuals with asymptomatic neurosyphilis or meningeal neurosyphilis usually return to normal health. People with meningovascular syphilis, general paresis, or tabes dorsalis usually do not return to normal health, although they may get much better. Individuals who receive treatment many years after they have been infected have a worse prognosis.

How can I or my loved one help improve care for people with neurosyphilis?

Consider participating in a clinical trial so clinicians and scientists can learn more about neurosyphilis and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with neurosyphilis at

Where can I find more information about neurosyphilis?

Information may be available from the following resources:

Centers for Disease Control and Prevention (CDC)


National Institute of Allergy and Infectious Diseases (NIAID)

Content source: Accessed June 23, 2023.

The information in this document is for general educational purposes only. It is not intended to substitute for personalized professional advice. Although the information was obtained from sources believed to be reliable, MedLink, its representatives, and the providers of the information do not guarantee its accuracy and disclaim responsibility for adverse consequences resulting from its use. For further information, consult a physician and the organization referred to herein.

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