神经梅毒医疗课件.ppt

神经梅毒医疗课件;概述;流行病学;流行病学;流行病学;流行病学;发病机制;;临床分类;病理;病理;病理;临床类型;临床分类 ;神经梅毒的分类与病理改变;神经梅毒的临床表现;神经梅毒的临床表现;神经梅毒的临床表现;神经梅毒的临床表现;神经梅毒的临床表现;神经梅毒的临床表现;神经梅毒的临床表现;麻痹性痴呆的临床表现归纳为PARESIS;神经梅毒的临床表现;神经梅毒的临床表现;神经梅毒的临床表现;神经梅毒的临床表现;神经梅毒的临床表现;神经梅毒的临床表现;神经梅毒的临床表现;神经梅毒的临床表现;神??梅毒的临床表现;神经梅毒的临床表现;实验室检查;脑脊液检查;;Tp中枢神经系统入侵的诊断;;;Tp累及中枢神经系统的诊断;;;;;;神经梅毒的诊断;;;;;神经梅毒的治疗;神经梅毒的治疗;;;;神经梅毒的治疗;A 46-year-old woman with a 15-month history of progressive dementia and personality changes was admitted to our hospital due to generalized seizures and a prolonged disturbance of consciousness. She tested positive for syphilis with a rapid plasma reagent. Fluorescent treponemal antibody absorption, measured for confirmation, was also positive.A human immunodeficiency virus test was negative.Axial fluid-attenuated inversion recovery magnetic resonance imaging (MRI) revealed bilateral frontal and right insular cortical lesions (Picture A) in addition to a mesial temporal lesion (Picture B) (1, 2). The patient received a 14-day course of penicillin G (18 million units/day) with a gradual improvement in consciousness. The seizures were successfully controlled with 800 mg/day of sodium valproate. MRI showed frontal and mesial temporal atrophy three months after treatment (Picture C and D).;A 55-year-old Caucasian man presented to our facility with acute collapse against a background of memory difficulties over the previous six months. A magnetic resonance imaging scan of his brain revealed high T2 signal intensity and atrophy within the right frontal area in addition to high T2 signal intensity in the bilateral mesial temporal areas. Blood and cerebrospinal fluid analysis revealed an active syphilis infection. An 18F-fluorodeoxyglucose positron emission tomography brain scan showed intensely increased 18F-fluorodeoxyglucose uptake limited to the head of the right hippocampus. He responded to penicillin treatment with an improvement in his cognition, which was further reflected in a complete resolution of the findings pre