Syphylitical Myelopathies: Study of 8 observations at National Hospital Ignace Deen, University of Conakry

Abstract

Introduction: Myelopathies occurring in the context of neurosyphilis have been poorly studied clinically,
radiologically and in tropical settings. The diagnostic certainty of the syphilitic etiology of myelopathy is
difficult to establish because of the multiplicity of causes of spinal cord damage.

Patients and Methods: We carried out a retrospective study of 269 patients hospitalized for spinal cord
disorders between January 2015 and December 2021, among whom 8 (eight) patients were identified
for progressive syphilitic myelopathy diagnosed by the positivity of VDRL-TPHA serological reactions
in the blood and cerebrospinal fluid and radiological data. Magnetic resonance imaging was performed
in all patients.

Results: The neurological signs were limited to the existence of a sensory-motor spinal semiology
in particular, paraparesis with sphincter disorders, especially moderate urinary disorders, without an
obvious infectious syndrome in a context of positive serological reactions VDRL-TPHA in the blood and
cerebrovascular fluid. spinal. Lumbar puncture shows hypercellularity with lymphocyte predominance
on average 65% and hyperproteinorachia varying from 0.98 to 1.36 g/l. magnetic resonance imaging
performed in all patients contributed to the diagnosis by showing hypersignals in T2, expression of more
or less extensive lesions on several segments.