Do you recommend routine neurosyphilis testing in patients being evaluated for dementia?  

Syphilis is a rare cause of dementia without other evidence of neurological disease, at least in the US and most other industrialized countries. Of course, a careful neurological examination is required for all dementia patients, but the absence of other manifestations of neurosyphilis makes testing...

The American Academy of Neurology does not recommend routine/mandatory testing for syphilis in all dementia cases, and I agree, due to extremely low pre-test probability in most patients. I think there is still a value of getting a history and doing a thorough exam before ordering this test. If a pa...