NEUROSYPHILIS
progressive loss of mental and physical fx
Treponema pallidum, spirochete, invades CNS
four stages, if you will:
1) asymptomatic (painless chancre, condyloma lata, urethral discharge green)
2) meningovascular (perivascular inflam presents as stroke of MCA or basilar branch in young person, these vessels being in the base of the skull, may result in cranial nerve palsies)
3) paretic (20-30 years, progressive: spirochetes invade parenchymal tissue-->inflam kills brain cells-->chronic perivascular and meningeal inflammatory changes-->brain atrophy)
4) tabes dorsalis (present with loss of pain sensation, bladder incontinence, loss of peripheral reflexes, impairment of vibration sense and proprioception, progressive ataxia dt demyelination of posterior column, inflam and fibrosis of dorsal sensory nerve roots-->ataxia, loss of pain and proprioception-->demetia-->vegetative-->death)(Argyl-Robertson pupil does not react to direct light but is consensually reactive and accomodative)
What's MCA?
( part 2, Miller notes: neurosyphilis, JC virus, measles (rubeola), polio, rabies, HIV, slow viruses (prions), and Reye's syndrome for good measure )