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General Paresis

Alternate Names

  • paretic neurosyphilis
  • Brain structures

Definition

General paresis is a chronic infection of the brain withthe organism that causes syphilis. It is a tertiary, or third-stage, form of syphilis that affects the brain and spinal cord.

What is going on in the body?

General paresis is a tertiary form of syphilis in which Treponema pallidum attacks the nervous system, causing a gradual mental and neurological decline. It develops in 5% of people with untreated syphilis. The symptoms generally appear 20 years or more after the initial infection.

Risks

What are the causes and risks of the disease?

General paresis is a long-term effect of an untreated syphilis infection.

Prevention

What can be done to prevent the disease?

If syphilis is recognized early in its course, it can be cured with antibiotics. General paresis develops only in those who go for years without treatment.
Preventive strategies also include the following:
  • Get a medical checkup promptly for any signs of sexually-transmitted infections (STIs), and follow through with treatment for oneself and one's partner(s) if syphilis or any other STI is found.
  • Limit sexual activity to one mutually faithful, lifelong partner who is not infected. Safer sex practices can reduce, but not eliminate, the risk of syphilis.

Diagnosed

How is the disease diagnosed?

Diagnosis of general paresis begins with a medical history and physical exam. Samples of blood and cerebrospinal fluid can be examined for signs of the infection. Cerebrospinal fluid is the liquid that surrounds the brain and spinal cord.

Long Term Effects

What are the long-term effects of the disease?

Some of the changes of general paresis are not reversible. The brain itself has been damaged, so treatment is important to stop the brain damage at the earliest possible time.
Dementia from any cause increases the risk of early death. It also makes a person less able to carry out normal daily activities.

Other Risks

What are the risks to others?

General paresis occurs after many years of a syphilis infection, when the person is no longer contagious.

Treatments

What are the treatments for the disease?

General paresis is treated with high doses of penicillin for two or more weeks. Treatment early in the course of general paresis improves the mental and physical symptoms in about 40% of people.

Side Effects

What are the side effects of the treatments?

Penicillin may cause allergic reactions, rash, or stomach upset.

After Treatment

What happens after treatment for the disease?

Treatment halts the progression of the disease 40% to 50% of the time. Neurological problems improve in 30% to 40% of cases. The cerebrospinal fluid has to be rechecked to be sure that the Treponemapallidum organism has been completely eliminated.
Sometimes, the penicillin treatment has to be repeated. Any new or worsening symptoms should be reported to the healthcare professional.

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