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Lightning pains of the extremities, decreased peripheral reflexes and urinary and fecal incontinence can also occur.General paresis is chiefly manifested by chronic dementia but can be accompanied by other neurologic signs as well.The VDRL and RPR, respectively, are reactive in 78 percent and 86 percent of patients with primary syphilis.8 They become positive within approximately four to six weeks after infection or one to three weeks after the appearance of the primary lesion.

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Tabes dorsalis, with its characteristic wide-based “steppage” gait, signifies destruction of the dorsal roots of the spinal column. Serologic tests can be negative if they are performed at the stage when lesions are present, and the VDRL test can be negative in patients with late syphilis.



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