A STUDY OF THE SPINAL FLUID IN FIFTY-TWO CASES OF CONGENITAL SYPHILIS
Journal of the American Medical Association (JAMA)
With a steady improvement in the technic of biologic tests at our disposal, and the increasing appreciation of spinal puncture, numerous and valuable contributions to our knowledge of syphilis of the central nervous system have been made during the last few years. Probably because of the possible difficulties to be encountered in this procedure with infantile cases, these studies, for the most part, have dealt with syphilis in the acquired form. In view of this fact, and as part of a preceding
... eries of similar studies from this clinic, the present analysis of spinal fluid findings in cases of hereditary syphilis was undertaken. In spite of the preponderance of similar studies having to do with neurosyphilis in the acquired form, the more recent literature contains occasional references to the inherited form of the disease. For the most part, moreover, these contributions have pointed out the types of possible accidents that may occur with involvement of the central nervous system in hereditary syphilis. Gaucher,1 Barbier and Gassier,2 Bresler 3 and Hubner 4 each have contributed exhaus¬ tive studies to this particular phase of the question. As a result of their studies, these authors have emphasized certain types of hydrocephalus, certain meningitides, including meningo-arterial involvement, gummas with localizing symptoms, and convulsions at different ages and of various types, as possible acci¬ dents of important frequency. Further, the question has been considered from the standpoint of certain other neurologic manifestations, attention having been called by Camp 5 to what is an apparent increase in the incidence of this type of involvement, and the growing importance of inherited syphilis as an etiologic factor in the hereditary degenerations, including certain of the muscular dystrophies. Notwithstanding valuable general considerations of the subject as mentioned above, routine examination of the spinal fluid of patients with hereditary syphilis has appar¬ ently been undertaken in surprisingly few instances. Jeans e has reported the results of such a study car¬ ried out in 214 cases. Combining lumbar puncture with a careful clinical examination, approximately a third of Jeans' cases show definite involvement. Such involvement varied from entirely asymptomatic cases with abnormalities in the spinal fluid alone to those cases with permanent changes presenting various pal¬ sies, hemiplegias, and certain types of mental deterio¬ ration. In a similar study, With7 has reported an Studies and Contributions of the Department of Dermatology and Syphilology of the University of Michigan, Service of Dr. Udo J. Wile.