Synonyms: dementia paralytica, general paresis of the insane, paretic neurosyphilis
Onset: typically 15 to 20 years after the initial infection if untreated. It may develop slowly or have an abrupt onset.
Psychiatric changes:
(1) change in personality
(2) depression
(3) loss of memory
(4) lack of insight and/or defective judgment
(5) irritability and/or agitation
(6) inability to concentrate
(7) delusions
(8) paranoia
(9) inappropriate social behavior
(10) apathy
(11) dementia
Ocular changes:
(1) Argyll Robertson pupil
(2) other pupillary changes (dilated, slow to react to light)
(3) optic atrophy with gunbarrel sight
Other changes:
(1) tremors of tongue, fingers, hands and facial muscles
(2) slurring and other speech abnormalities
(3) abnormal reflexes (often hyperactive)
(4) headache
(5) insomnia
(6) seizures
(7) stroke
(8) aphasia
(9) expressionless face
