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General paresis

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Definition:

General paresis is an impairment of mental function caused by damage to the brain from untreated syphilis. It is now extremely uncommon.

Causes, incidence, and risk factors:

General paresis is one form of neurosyphilis . It is a complication of a late, untreated syphilis infection. General paresis is a progressive, life-threatening complication.

The syphilis infection causes widespread damage to the nerves of the brain. This damage results in personality changes, mood changes, hyperactive reflexes, eye changes with abnormal pupil response, abnormal mental function including hallucinations and delusions, decreased intellectual functioning, speech changes, and brief, sharp, "lightning" pains that are characteristic of tabes dorsalis .

General paresis typically begins about 15-20 years after the original syphilis infection. The risks include previous syphilis infection and previous infection with other sexually transmitted diseases, such as gonorrhea (which may hide symptoms of syphilis infection). Syphilis infections are transmitted primarily through sexual contact with an infected lesion, but may also occasionally be transmitted by non-sexual contact.

References:

Moore DP, Jefferson JW. Handbook of Medical Psychiatry . 2nd ed. St. Louis, Mo: Mosby; 2004:404-406.

Goetz, CG. Textbook of Clinical Neurology . 2nd ed. St. Louis, Mo: WB Saunders; 2003: 931-933.

• Review Date: 4/28/2006
• Reviewed By: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.

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