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
1. What is the proper definition of pseudoparesis? Fournier termed
pseudoparesis certain cases that looked like paresis but were not
syphilitic in origin. Of these cases the most characteristic group
is that of alcoholic pseudoparesis. It is clear that there will be
no difficulty in the definition of a disease pseudoparesis whose
entity is presented in the adjective that precedes the term
(_e.g._, alcoholic pseudoparesis). According to this usage, a case
of pseudoparesis would be one in which the symptoms and possibly
some of the signs somewhat resemble the symptoms of paresis itself
but for which another etiology could be fairly established.
2. Are there any cases of syphilitic pseudoparesis? We are of the
opinion that the term should be dropped. It is true that there are
cases which clinically look like general paresis and exhibit the
appropriate laboratory signs of general paresis but seem to differ
from paresis in their course even when they receive no treatment
whatever. In the present phase of doubt as to the classification
of paretic and non-paretic forms of neurosyphilis, it seems to us
of doubtful utility to characterize a case as pseudo simply
because it differs in its course, particularly as the literature
has always duly recognized that a number of cases of general
paresis have had long courses and sometimes very long remissions.
There is also another group of cases that have been termed cases
of pseudoparesis, namely: certain cases of neurosyphilis which
clinically look like general paresis and seem to be following its
classical course but are interrupted by treatment. Here again it
seems to us doubtful whether the designation pseudo should be
attached to this group of cases, particularly while the whole
therapeutic question in the paretic group of neurosyphilis cases
remains _sub judice_. Accordingly we are tempted to include in the
group of paretic neurosyphilis cases that either get well of
themselves, or get well under treatment, or pursue a very long
course, or are subject to very long remissions. But we make this
decision in terminology without prejudice to the therapeutic
question and it is open to any critic to throw these cases into an
atypical non-paretic group of neurosyphilis cases.
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