精神障碍合并癫痫发作的神经梅毒2例并文献复习

Neurosyphilis with Manifestations of Mental Disorders Combined with Epileptic Seizures:Two Cases Report and Literature Review

目的探讨精神障碍合并癫痫发作的神经梅毒的诊治。方法分析以"精神障碍合并癫痫发作"为主症的2例不典型神经梅毒患者的临床资料,并复习相关文献。结果 2例均有精神异常伴癫痫发作,1例有吸毒及冶游史,2例血清、脑脊液RPR及TPPA均阳性,1例脑脊液蛋白升高。经驱梅治疗后,临床症状均明显好转。结论以不明原因的精神障碍合并癫痫发作为首发症状的患者建议常规行梅毒筛查;确诊神经梅毒的患者应及时规范应用青霉素驱梅治疗。

Objective To discuss the diagnosis and treatment of neurosyphilis with manifestations of mental disorders combined with epileptic seizures.Methods The clinical data of two cases of atypical neurosyphilis with mental disorders and epilepsy as the main symptoms were retrospectively analyzed.Results Two cases showed mental abnormality with epileptic seizures,one had the history of drug addiction and non-marital sexual life,both had positive RPR and TPPA in serum and cerebrospinal fluid,and one case of cerebrospinal fluid protein elevated.The clinical manifestations of both patients were significantly alleviated after the treatment of anti-syphilitics.Conclusion Patients who had unexplained symptoms such as mental disorders and epileptic seizures as the main manifestations should routinely take the syphilis screening. Patients diagnosed with neurosyphilis should be treated with penicillin G normatively and timely.