The primary treatment for neurosyphilis involves high doses of intravenous penicillin administered over an extended period. The standard regimen includes:
Intravenous aqueous crystalline penicillin G: 18-24 million units per day, administered as 3-4 million units every 4 hours for 10-14 days Alternative treatment options for penicillin-allergic patients may include ceftriaxone or doxycycline, though penicillin desensitization is preferred
Follow-up care is crucial, with repeat lumbar punctures at 6-month intervals until the CSF abnormalities have resolved.
