Epileptic Seizures As A Neurological Complication

Reiter syndrome is classically characterized as the clinical triad of arthritis, urethritis, and conjunctivitis. Similar disease entities have been previously described by Stoll in 17761 as of postenteric origin and by Brodie in 18181 as a postvenereal syndrome. The German hygienist Hans Reiter reported in 19162 a case in which a young lieutenant developed purulent urethritis, conjunctivitis, arthritis, and iritis after an episode of bloody diarrhea, and he named the condition "spirochaetosis arthritica." The term Reiter syndrome was formally described by Bauer and Engelman in 1942,3 and the reports of Paronen4 and Noer5 conclusively associated epidemic dysentery with the onset of Reiter syndrome. Young adults are most commonly affected at a suggested male-female ratio of 5: 1 or 6: 1, and the disease onset peaks during the third decade oflife. The increased occurrence of the histocompatibility antigen HLA-B27 in patients with Reiter syndrome has been known since 1973 6 and is found in 75 to 80 percent of all patients. Reiter syndrome is preceded by specific gastrointestinal or genitourinary infections, and there is a distinct geographic variation of the triggering infectious organism. In the United States and United Kingdom the posturethritic-venereal origin is the more common form, with Chlamydia trachomatis or Mycoplasma species as the precipitators of arthritis. In other parts of the world Shigella, Salmonella, and Yersinia species have been implicated in the postdysenteric form of the disease. The acute or subacute articular manifestations follow the triggering infectious episode with a latency period ranging from a few days to 3 weeks. The arthropathy is typically a rheumatoid factor-negative asymmetric oligoarthritis involving knees, ankles, and feet, and during the acute phase low