Present clinical presentations of syphilitic dementia: A study of 9 observations at the Department of Neurology, Teaching Hospital, University of Conakry

Introduction: In sub-Saharan Africa (SSA), clinical and biological diagnostic certainty in syphilitic dementia is difficult to establish due to under-medicalisation and late consultations. Material and methods: We conducted a retrospective study of 298 patients hospitalised for dementia syndromes between 2010 and 2019 in the neurology and psychiatry departments of the Teaching Hospital, University of Conakry. A syphilitic etiology was retained for 9 patients. Results: The 9 patients for whom a syphilitic etiology was retained were aged 55 to 76 years (3 women and 6 men). A clinical presentation, dominated by memory disorders, with decreased ideation, personality and behavioural disorders and pseudo depressive syndrome, was noted for these patients. The profile also included the presence of neurological signs: Argyl–Robertson sign (5 cases), vermicular tremor of the labio-lingual region (3 cases), sphincter disorders (3 cases) and pseudo-Parkinsonian facies (6 cases). The diagnosis was confirmed via the positivity of serological reactions (VDRL-TPHA) in the blood and cerebrospinal fluid, and the presence of predominantly lymphocytic hypercellularity and hyperproteinorachia. Conclusion: These neurological syndromes pointing to cerebral syphilitic involvement are the result of as yet poorly managed treatment of primary and secondary syphilis in our country.