Signs and symptoms of neurosyphilis:
(1) general paresis (dementia paralytica): dementia, convulsions, delusions, headaches, defective judgment, etc.
(2) Argyll Robertson pupil
(3) tabes dorsalis (locomotor ataxia)
(4) cerebral gumma
Criteria for Definitive Diagnosis:
(1) reactive serum treponemal test
AND
(2) one or both of the following
(2a) reactive VDRL CSF test on spinal fluid sample
(2b) identification of T. pallidum on CSF or tissue by microscopic examination
(2c) identification of T. pallidum on CSF or tissue by animal inoculation
Criteria for Presumptive Diagnosis:
(1) reactive serum treponemal test
AND
(2) one or both of the following:
(2a) clinical signs of neurosyphilis
(2b) elevated CSF protein ( > 40 mg/dL) in the absence of other known cause
(2c) elevated CSF leukocyte count ( > 5 mononuclear cells per µL) in the absence of other known cause
