Changing clinical picture of neurosyphilis: report of seven unusual cases.

August von Wassermann was born in Bavaria just over a century ago, and perhaps it is therefore fitting to report a small group of patients in which serious diagnostic difficulties were resolved with the aid of the complement-fixation test now named after him. We also report these cases in order to draw attention to the fact that neurosyphilis, though uncommon, is not nowadays as rare as some would have us believe and that the disease may present in a variety of unfamiliar guises. We have analysed all the cases in which a positive \Vassermann reaction or Reiter test was obtained over a ninemonth period, after patients with a known history of syphilis had been excluded. During the period of study a W.R. and Reiter test was performed on 493 neurological admissions, of which seven were found to be positive. All seven patients were subsequently shown by further serological tests to have syphilis and the cases are described below.