Frequent errors of diagnosis must occur in the field of the senile psychoses. We present a case that would at first blush warrant the diagnosis of senile arteriosclerotic psychosis[[99]] in a sea captain of 75 years (wife dead 15 years before of general paresis) who turned out to be a characteristic case from the laboratory standpoint of Neurosyphilis.
The Protean nature of the symptomatology of neurosyphilis is sufficiently established. Still, a case that might fit into textbooks concerning Dissociation of Personality[[100]] is certainly a clinical oddity, as illustrated by a fugacious musician.
A case with strong suspicions of neurosyphilis of tabetic type turned out to be more probably one of neural complications in Pernicious Anemia.[[101]]
Neurosyphilis in Juveniles presents puzzling conditions.
One case was marked clinically by attacks of excitement.[[102]] It is impossible to place this case among the main groups of juvenile neurosyphilis.
Another case of Feeblemindedness,[[103]] also Neurosyphilitic in origin, presented physical symptoms and laboratory signs of paretic neurosyphilis; yet this case had been considered one of simple feeblemindedness.
A case apparently of Juvenile Paretic Neurosyphilis in a 15 year old boy presented the rather unusual complication of shocks with quadriplegia,[[104]] a vascular complication not usually expected in the paretic type of neurosyphilis in adults.
Epileptic phenomena[[105]] are rare as the effect of Juvenile Neurosyphilis, but occur as demonstrated in a case which slipshod methods of diagnosis might well have regarded as one of idiopathic epilepsy.
A case of Juvenile Paretic Neurosyphilis with the complication of Addison’s Disease[[106]] is given (autopsy confirmation).
The puzzle in diagnosis offered by syphilis in the secondary stage[[107]] is illustrated by a case which showed the characteristic Neurosyphilitic complications of the Secondary Stage of syphilis. This patient may well have been a moron at the outset and exhibited some reactions (refusal to talk) explicable on the basis of feeblemindedness. She was a neurosyphilitic only in the sense of the neural complication that we find in the secondary stage of syphilis. As stated above, we do not yet know what the fate of these neural complications of secondary syphilis is to be. The frequency of this finding in secondary syphilis is probably too great to warrant the hypothesis that it must always go on to a chronic neurosyphilis; but we certainly are warranted in regarding these cases as potential chronic neurosyphilitics.