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General paresis has only one highly suggestive sign, the Argyll Robertson pupil. The AR pupil is small and irregular; it accomodates to near vision but not to light. The other symptoms are nonspecific and may suggest other neurologic diagnoses, e.g. Alzheimer�s disease in an elderly patient. The presence of a peripheral serology specific for syphilis (e.g., FTA-ABS) and a reactive CSF VDRL, with or without neurologic findings, should prompt treatment for neurosyphilis. |