It is now known that the central nervous system is involved in a large percentage of patients in the early stage of syphilis. Such involvement may be expressed clinically as symptoms of acute meningitis and meningo-encephalitis in which papilledema may be a conspicuous symptom. Early neurosyphilis is therefore of interest to the ophthalmologist.
The purpose of this paper is a discussion of papilledema as an expression of acute syphilitic meningitis, an analysis of fifty reported cases and the report of a typical case.
Papilledema of syphilitic origin is almost invariably a symptom of acute syphilitic meningitis or meningo-encephalitis. The latter process may occur in the three following stages of syphilitic infection ; more commonly during the secondary stage, either before, during or soon after the secondary exanthem, much less commonly as an acute exacerbation in congenital syphilis and in latent periods during the tertiary stage of acquired