Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case historiesSouthard, Elmer Ernest
Science
Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case histories
Southard, Elmer Ernest
Neurosyphilis
form of antisyphilitic treatment. This condition is sometimes
known as a post-syphilitic epileptic neurosis. Nonne had been able
to collect up to 1902 some 12 cases from his own service.
4. Would it be proper to call Borofski a case of taboparesis? Absent
knee-jerks in a victim of paretic neurosyphilis should not be used
to suggest a diagnosis of taboparesis. This question of
terminology has been discussed above, under Sullivan (16).
5. What is the mechanism by which the amnesia of a case like
Borofski is produced? The answer runs in the same terms as the
answer to the questions concerning the cause of convulsions. The
amnesia in general paresis has surprising functionality. A study
of autopsied cases of general paresis has shown that amnesia is
practically as common in cases without marked destruction of brain
tissue as in cases with atrophy of classical extent and depth. The
clinical recovery in this case was practically complete in respect
to memory. We must regard the amnesia as not due to the
destruction of storage cells bearing the so-called neurograms
(Morton Prince).
6. What is the explanation of the persistently positive W. R.’s of
the serum and spinal fluid associated with diminished globulin and
albumin tests, a negative gold sol reaction, and normal cell
count? See discussion under Case Martha Bartlett (21).
7. How atypical is the early development of paretic symptoms in
David Borofski? C. B. Craig has collected, in 100 cases of brain
syphilis (a list including both paretic and non-paretic cases),
some data on this point. The shortest period reported by Craig was
in a case in which the neurosyphilitic symptoms appeared one month
after infection. Craig found three cases where symptoms appeared
in six months, and six cases within a year. The longest
post-infective period of Craig’s list was thirty years. Our case
of Chatterton (73) developed symptoms 33 years after infection and
Washington (66), forty years after infection. Nonne casts some
doubt on statements to the effect that tabetic symptoms may occur
three to four months after infection. It seems to be admitted that
pupillary anomalies and reflex changes may occur in the early
secondaries and may recover under antisyphilitic treatment.
Nonne’s case of longest post-infective interval, like that of
Craig, was one of 30 years.
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