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Definition Return to top
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 Return to top
General paresis is one form of neurosyphilis, which is a manifestation of a late, untreated syphilis infection. It is a progressive, life-threatening complication.Symptoms Return to top
Signs and tests Return to top
An eye examination may indicate a change in pupil response. A neurologic and muscular examination indicates slowly progressive dementia, with loss of multiple brain functions. Muscle weakness may be evident. There may be a loss of vibratory and position sense. Gait disturbances are common. The person may be unable to stand with the eyes closed (Romberg test).Treatment Return to top
The goals of treatment are to cure the infection and reduce progression of the disorder. Treatment of the infection will reduce new nerve damage, but will not cure existing damage. Penicillin or other antibiotics, such as doxycycline, are given to treat the infection. Treatment may be prolonged to ensure that the infection is completely cleared. A follow-up examination of the cerebrospinal fluid is required to evaluate the effectiveness of antibiotic therapy.Expectations (prognosis) Return to top
Progressive disability is likely. People with late syphilis infections are more prone to the development of other infections and diseases. If not treated, progressive disability is likely.Complications Return to top
Complications include the inability to care for oneself, the inability to communicate or interact, injury caused during seizures, and injury from falls (related to unsteady gait).Calling your health care provider Return to top
Call your health care provider if the symptoms of general paresis are present, particularly if there is a known history of syphilis infection.Prevention Return to top
Adequate treatment and follow-up of primary syphilis and secondary syphilis infections will prevent general paresis.
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Page last updated: 28 October 2004 |