Meningovascular neurosyphilis: cognitive and neuropsychiatric impact

Neurosyphilis is commonly viewed through the prism of the pre‐penicillin era when parenchymatous neurosyphilis was seen more commonly and presented as general paresis of the insane. In the post‐antibiotic era, meningeal and vascular forms of syphilis are more commonly seen and can present as a stroke. Here, the authors present a case of a 47‐year‐old man with meningovascular neurosyphilis confirmed by CSF serology who presented with cognitive, mood, psychosis, gait changes and sudden‐onset severe vertigo indicative of syphilitic apoplexy.