Abstract:Objective To explore the clinical characteristics of inpatients with symptomatic neurosyphilis. Methods A retrospective study was conducted on the clinical data from 50 symptomatic neurosyphilis inpatients, aged (58.16±10.36) years and 84.00% male, who were admitted to the Department of Neurology,the Second Hospital of Nanjing from February 2019 to May 2021. According to the results of brain magnetic resonance imaging (MRI), inpatients were divided into MRI bilateral abnormal group (n=25) and MRI normal/unilateral abnormal group (n=25) for intergroup comparison. Results There were 33 cases of parenchymal type of neurosyphilis, 11 cases of meningovascular type, 4 cases of myelopathic type, and 2 cases of meningeal meningitis type, accounting for 66.00%, 22.00%, 8.00% and 4.00% respectively. Forty-two cases were positive for toluidine red unheated serum test (TRUST) in cerebrospinal fluid (CSF), accounting for 84.00%. All 50 cases were positive for treponema pallidum particle assay (TPPA) in CSF. Compared with MRI normal or unilateral abnormal group, the patients in MRI bilateral abnormal group had a older age (t=2.798, P=0.007), a higher proportion of underlying diseases (48.00% vs 20.00%, χ²=4.367, P=0.037) , and a higher quantification of CSF protein（t=2.130, P=0.038), all with statistical differences. Conclusion The clinical manifestations of neurosyphilis are variable, and diagnosis of neurosyphilis should be based on clinical manifestations, CSF and imaging examination. The imaging findings of elderly patients and patients with underlying diseases predict that the disease are more severe, so special attention should be paid to the patients mentioned above. In addition, neurosyphilis should be as a risk factor for cerebrovascular disease. Timely reducing CSF protein levels may improve the prognosis of patients with neurosyphilis.