Symptoms:

• Abnormal walk (gait)
• Blindness
• Confusion
• Dementia
• Depression
• Headache
• Incontinence
• Inability to walk
• Irritability
• Numbness in the toes, feet, or legs
• Poor concentration
• Seizures
• Stiff neck
• Tremors
• Visual disturbances
• Weakness

Note: There may be no symptoms.

Signs and tests:

Signs include:

• Abnormal reflexes
• Muscle atrophy
• Muscle contractions

Blood tests can be done to detect substances produced by the bacteria that cause syphilis. The oldest test is the VDRL test.

Other tests include:

• Fluorescent treponemal antibody absorption (FTA-ABS)
• Rapid plasma reagin (RPR)
• Treponema pallidum particle agglutination assay (TPPA)

In neurosyphilis, it is important to test the spinal fluid for signs of syphilis.

Tests to look for problems with the nervous system may include:

• Cerebral angiogram
• Head CT scan
• Lumbar puncture ("spinal tap") and a cerebrospinal fluid analysis (CSF fluid analysis)
• MRI scan of the brain, brainstem, or spinal cord