General Paresis – Neurosyphilis — SCE Neurology MCQ

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ModerateCNS InfectionsGeneral Paresis – NeurosyphilisSCE Neurology

A 55-year-old man has a positive CSF-VDRL, progressive dementia, personality change, dysarthria and later-onset seizures. Which late neurological manifestation of syphilis best explains this syndrome?

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Correct answer: B — General paresis

General paresis is a progressive dementing syndrome due to cortical neuronal loss in late neurosyphilis; personality change and cognitive decline precede severe dementia, seizures and hemiparesis. Tabes dorsalis causes dorsal-column and root symptoms, while meningovascular disease causes arteritic stroke and gumma produces a focal granulomatous lesion.

Reference: BASHH UK syphilis guideline 2024: https://www.bashh.org/_userfiles/pages/files/syphilis_2024.pdf?UNLID=712016336202581475056