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
Table 1: Effects of damage to upper and lower motor neurones
Upper motor neurone lesionLower motor neurone lesion
ParalysisSpastic-type contractureFlaccid-type contractures may develop
Tendon reflexesExaggerated; hyperreflexiaReduced/absent; hyporeflexia
Plantar responseExtensor (Babinski's sign positive)Flexor (= normal; Babinski's sign negative)
Extraneous muscle activityNo fasciculations/fibrillationsFasciculations and fibrillations