• With the widespread use of serum VDRL testing and penicillin therapy, the prominence of syphilis as an occult cause of neurologic disease has receded. Recent statistics from the Centers for Disease Control, Atlanta, reflect an increase in cases of primary syphilis, promising that more cases of neurosyphilis will arise to confound the unwary clinician. We studied an unusual case of neurosyphilis and developed a rational basis for antibiotic treatment of this condition.