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
3. The cell count may vary greatly from month to month, or when
the interval is but several days, while at other times it may
remain very nearly the same after an interval of months.
4. Cases showing natural remissions may show no reduction in the
cell count, or other spinal fluid findings.
5. Cases treated with salvarsan, either intraspinously or
intravenously, tend to show a more or less rapid fall in the cell
count. This count will, as a rule, remain low during treatment,
but is likely to rise when treatment has been discontinued, but
may rise during treatment after having first fallen.
6. Cases may show remissions during treatment and still have a
pleocytosis.
7. Treated cases having the cell count fall to normal may at the
same time become very much worse and develop more marked paralytic
symptoms.
8. In general paresis the cell count in no way parallels the other
spinal fluid findings.
9. In cases in which the other tests show an improvement, for
instance cerebrospinal syphilis, the cell count also readily and
early drops to normal. At times it may drop to normal before other
spinal fluid tests become negative; again it may be last to reach
normal.
10. The change in cell count seen in syphilitic disease untreated
is also found in non-syphilitic diseases, as brain tumor.
11. The cell count offers nothing of prognostic importance in
syphilis of the nervous system unless accompanied by improvement
of the other laboratory signs.
12. The cell count is not an index to the predominance of
irritative or degenerative changes.
=Case of CEREBRAL MALARIA and SYPHILIS: simulation of PARETIC
NEUROSYPHILIS (“general paresis”).=
=Case 67.= Joseph Temple, 45, who had been a sea-going steamboat
steward, was brought to the hospital in a semi-stupor. He was entirely
uncoöperative, often resistive, attempting to bite the physician’s
fingers, and for the most part lying curled up. He was incontinent and
tube-fed. This phase, it seems, had begun the night before entrance to
the hospital. Twenty-four hours later, an extraordinary change was
noted. Temple became alert and attended to his wants, began to eat well,
and began to behave as normally as probably he ever behaved.
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