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Case Neurosyphilis

Case Neurosyphilis

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Published by: Francisco Mendez de Peña on May 30, 2012
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05/09/2013

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Case: Neurosyphilis

A 45 year old male with history of untreated venereal disease complains of pain in his legs and difficulty walking, especially in the dark. For the past year, the patient has noted sporadic episodes of electric like lightning pain in his leg that last for hours or days. He also complains of persistent numbness and tingling in his feet and has been stumbling whenever he turns quickly. His vital signs are normal. In the physical exam is important the discrepancy in pupillary size; invloved pupil reacts poorly to light but normally to accomodation; cranial nerves grossly intact; motor exa is 5/5 bilaterally throughouth, deep tendons reflexs are symmetric in upper extremities but absent at patella and achilles; Babinski’s sign absent bilaterally; sensory exam reveals drecreased vibratory and propioception sense in feet; Romberg’s sign positive, patient maintains knees in an extended position; finger to nose intact bilaterally.

Cell blood count: normal Prothrombin time: normal Partial tromboplastin time: normal Glucose: normal FTA-ABS: positive Lumbar puncture: lymphocytic pleocytosis, protein of 80 mg/dl, normal glucose, positivre FTA-ABS. QUESTIONS: 12345678Define syphilis, sing and symptons. Stages of syphilis Explain the clinical findings of the patient. Explain the treatment. Complications of syphilis: charcot’s joints and others. Tracts affected of the spinal cord: functions. What is Argyll- Robertson pupil? What is Romberg’s sign?

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