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Mao S et al. – The large scale use of antibiotics in recent years has changed the face of neurosyphilis, as it has been accompanied by a drop in incidence and frequent replacement of typical forms of presentation with atypical or masked forms. Herein, the authors describe three patients who presented initially with intermittent stabbing, or lightning–like pains in the extremities that lasted for several years, who were subsequently diagnosed as having neurosyphilis during a clinical evaluation. The clinical symptoms underlying neurosyphilis are complex, rendering diagnosis and treatment difficult. Therefore clinicians must learn to recognize these symptoms to improve patient outcomes.

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