What Does This CSF Analysis Report Indicate?
Not necessarily.
Detailed Answer:
I read your question carefully and I understand your concern.
It is true that FTA-ABS test in the CSF is the most sensitive test for neurosyphilis. So if you need a short answer, if you want the one single test to definitively rule out neurosyphilis then FTA-ABS of CSF would be the one, if negative it would rule it out.
However, often one can reach to such conclusions even looking at the situation as a whole. You have had more than one test which is negative. In over 70% of cases, there are changes in cell and protein levels.
Furthermore, CSF VDRL is negative. Admittedly there may be false negatives, but combined with the non raised cell count, I would say that it is very reassuring.
So unless clinical picture (of which not much info is presented) is highly suggestive of neurosyphilis, I wouldn't necessarily do FTA-ABS. If on the other hand, the clinical suspicion is strong then FTA-ABS should be done.
I remain at your disposal for other questions.
Regards
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Detailed Answer:
It does remain positive in the blood for many many years, in most people for life. However, after decades of non-exposure to the antigen in some individuals, it may turn negative.
There are no studies that I know of on percentages of people turning negative as it would require repeat testing of healthy patients for decades, not really an interest in that. But as I said, it remains positive for many years, longer than other tests, even for life.
Let me know if I can further assist you.
Regards
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Detailed Answer:
Those symptoms you describe are non-specific, meaning they can be manifested in a variety of settings and conditions. While it can manifest in a variety of ways neuro syphilis is certainly not the most common cause. So, given the normal tests as well I certainly do not see any reason to suspect it and do not think CSF FTA-ABS necessary based on those symptoms alone.
Withdrawal from Clonazepam, on the other hand, would explain the symptoms well, it can lead to anxiety exacerbation which can manifest in many ways. After 20 years of usage, it is not an easy process, it will be tough.
Withdrawal should be as gradual as possible if symptoms worsen after a lowering of the dose maybe dose should be brought back to prior dosage for some more time and lowered more gradually.
At times when there is a chronic anxiety, disorder medication may be necessary, not with benzodiazepines like clonazepam which is not appropriate for long term use as they cause physical dependence and tolerance, but antidepressant which are the most commonly used anti-anxiety medication.
I hope to have been of help.
Regards
Hope you feel better soon.
Detailed Answer:
Thank you for your kind words. Hope you feel better soon.