神经梅毒延迟诊断一例临床分析

摘要

Objective To investigate the clinical features and diagnostic methods and the causes of delayed diagnosis of neurosyphilis in new age. Methods We reported one case with neurosyphilis. The clinical features of neurosyphilis were analyzed. In the new age, the neurosyphilis was easy to make delayed diagnosis because its concealed. Results Patients ' ages were mainly midage. Cognitive disordes and mental disorders and epileptic seizure were main clinical manifestations. All patients s Treponema pallidum particle assay ( TPPA ) were positive.Brain MRI had no characteristic change. General paresis of insane could he cure and the MOCA score could be up.Conclusions Because of the complex clinical manifestations, the rate of misdiagnose is high. TPPA should be detected as a routine item. General paresis of insane could be cure.%目的 探讨麻痹性痴呆的临床特征、诊断方法 及延迟诊断原因.方法 结合1 例麻痹性痴呆患者的临床资料进行讨论,阐述新时期神经梅毒的隐蔽性和造成延误诊断的原因.结果 麻痹性痴呆中年人发病较多;起病隐匿,进行性加重,主要表现为认知障碍、精神症状、癫疒 间发作等;梅毒螺旋体明胶凝集试验(TPPA)阳性;头颅MRI无特征性改变;通过驱梅治疗麻痹性痴呆患者MOCA评分提高.结论 神经梅毒临床表现复杂,早期误诊率高;建议梅毒血清抗体检测应作为青壮年卒中或痴呆患者的常规检查项目;麻痹性痴呆是一种可治的痴呆,应及早诊断及早治疗.