general paralysis of the insane
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general paralysis of the insane (GPI)A now rare form of dementia from SYPHILIS of the nervous system. GPI was a feature of the third (tertiary) stage of untreated syphilis and occurred 10–20 years after infection in a small proportion of cases. The condition is characterized by delusions of grandeur, mania and sometimes delusions of persecution.
general paralysis of the insane; GPI tertiary syphilis, characterized by Argyll Robertson pupils, dementia, progressive cognitive decline, upper motor neurone dysfunction (exaggerated tendon reflexes and an extensor plantar response; see Table 1), fits, tremor and generalized motor paresis
|Upper motor neurone lesion||Lower motor neurone lesion|
|Paralysis||Spastic-type contracture||Flaccid-type contractures may develop|
|Tendon reflexes||Exaggerated; hyperreflexia||Reduced/absent; hyporeflexia|
|Plantar response||Extensor (Babinski's sign positive)||Flexor (= normal; Babinski's sign negative)|
|Extraneous muscle activity||No fasciculations/fibrillations||Fasciculations and fibrillations|