Читать книгу Neurosyphilis. Modern Systematic Diagnosis and Treatment Presented in One Hundred and Thirty-Seven Case Histories онлайн

60 страница из 85

Physically,Mentally,

TYPICAL LABORATORY FINDINGS IN NEUROSYPHILIS (Nonne, 1915) Diagnosis W. R., Blood Serum W. R. 0.22 cc. Blood Serum Spinal Fluid, 1.0 cc. Phase I, Globulin Pleocytosis PARESIS OR TABOPARESIS POSITIVE IN ALMOST 100% POSITIVE, 85–90% POSITIVE, 100% POSITIVE, 95–100% POSITIVE, ABOUT 95% TABES (not combined with paresis) POSITIVE, 60–70% POSITIVE, 20% POSITIVE, 100% POSITIVE, 90–95% POSITIVE, 90% CEREBROSPINAL SYPHILIS POSITIVE, 70–80% POSITIVE, 20–30% POSITIVE ALMOST ALWAYS POSITIVE almost always; NEGATIVE only EXCEPTIONALLY POSITIVE ALMOST ALWAYS Chart 8

Syphilitic thrombosis. Contours of brain preserved.

The W. R. proved positive in blood and spinal fluid. The gold sol reaction was of the syphilitic type; 37 cells were found per cmm.; there was a slight amount of globulin and a slight excess of albumin.

We made a diagnosis of Cerebrospinal Syphilis rather than general paresis on account of, first, the slow course of the disease; second, the vascular type of the cerebral insult, hardly typical of paresis; and third, the mild spinal fluid reaction. Treatment will hardly cure the hemiplegia, at least so far as restoration of cerebral tissues lost in the insult is concerned. We were perhaps entitled to consider that, as in the cases of Petrofski (17), O’Neil (19), Robinson (45), the meningitic process could be arrested. Unfortunately, our treatment of 20 injections of salvarsan over a period of 10 weeks, followed by a number of months of bi-weekly injections of mercury salicylate, proved incapable of making any change in the mental and physical picture or in the laboratory findings.