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Neurology in practice: The lexicon of syphilis

The following glossary is designed to provide clarity and insight into the specific terms associated with syphilis and congenital syphilis, highlighting the depth and breadth of the medical community's response to these diseases.

Terms primarily associated with syphilis acquired in adulthood

Argyll Robertson pupils: Small, irregular pupils unreactive to light (ie, they do not constrict when exposed to light) but reactive to accommodation (ie, they constrict when focusing on a near object).

Charcot joint (neuropathic arthropathy): Although not exclusive to syphilis, Charcot joints can occur in advanced stages of neurosyphilis. With this condition, joints degenerate due to loss of sensation, leading to swelling, instability, and deformity.

Chancre: A painless ulcerative sore, typically the first sign of primary syphilis.

Congenital syphilis: Syphilis passed from an infected mother to her fetus.

Darkfield microscopy: A method to visualize Treponema pallidum in tissue samples.

FTA-ABS (fluorescent treponemal antibody absorption): A more specific test for syphilis antibodies.

General paresis of the insane (GPI): This term was historically used to describe a form of neurosyphilis that leads to progressive dementia and psychiatric symptoms, along with physical deterioration.

Gumma: A soft, tumor-like growth of inflammatory tissue occurring in tertiary syphilis.

Heubner arteritis: An inflammation of the recurrent artery of Heubner and its tributaries leading to its occlusion, typically producing a pure motor stroke with fasciorachiocrural predominance. This is the most characteristic manifestation of meningovascular syphilis.

Latent syphilis: A symptom-free phase of syphilis following the secondary stage.

Lues: Syphilis.

Luetic: A person with syphilis; related to syphilis.

Meningovascular syphilis: A form of neurosyphilis involving the small arteries in the brain and meninges.

Neurosyphilis: Involvement of the nervous system by syphilis.

Primary syphilis: The initial stage of syphilis, characterized by the presence of a chancre.

RPR (rapid plasma reagin): A blood test used to screen for syphilis.

Secondary syphilis: The second stage of syphilis, marked by a rash, fever, and lymphadenopathy.

Syphilis: A sexually transmitted infection caused by the bacterium Treponema pallidum.

Tabes: From the Latin, meaning "wasting" or "decay."

Tabes dorsalis: A form of neurosyphilis characterized by progressive degeneration of the sensory neurons in the dorsal columns of the spinal cord. Clinically, it leads to sensory ataxia (unsteady gait and impaired balance, particularly in the dark or with eyes closed), sharp and shooting pains, and other sensory disturbances.

Taboparesis: A combination of tabes dorsalis and general paresis, presenting both the ataxic and mental symptoms associated with neurosyphilis.

Tertiary syphilis: The late stage of syphilis, which can cause severe damage to various organs.

Treponema pallidum: The bacterium that causes syphilis.

VDRL (Venereal Disease Research Laboratory): A test to detect syphilis based on antibodies.

Wassermann test: A test for syphilis based on the reaction of blood or cerebrospinal fluid obtained from a patient suspected to have syphilis, originally to an extract from human or monkey tissue rich in Treponema pallidum. A positive reaction presumed the presence of antibodies to the spirochete. The RPR and the VDRL have replaced the Wasserman test.

Terms specifically associated with congenital syphilis

Clutton's joints: Painless swelling of the knee joints in congenital syphilis.

Hutchinson's teeth: Notched, peg-shaped teeth seen in congenital syphilis.

Hutchinson's triad: The combination of Hutchinson's teeth, interstitial keratitis, and eighth nerve deafness.

Saddle nose: A collapsed nasal bridge seen in some cases of congenital syphilis.

Sabre shin: Abnormal shin bone curvature due to congenital syphilis.

Mulberry molars: Malformed molars with multiple small, rounded cusps resembling a mulberry’s surface, seen in congenital syphilis.

Rhagades: Linear scars at the angles of the mouth and around the anus and genitalia, caused by skin lesions and fissures that occur as a result of syphilitic infection. A sign of congenital syphilis.

Pseudoparalysis of Parrot: Apparent paralysis in infants due to painful bone lesions from congenital syphilis.

MedLink acknowledges the use of GPT-4 in drafting this blog entry.

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