I was watching the TV show SVU last night, and the story was about a serial killer. They finally drag the guy in, and he’s delusional, hearing voices, convinced that God is telling him to kill these people, etc. They run some tests, and discover he had a very advanced case of syphillis. It had eaten away, I forgot the medical term, the moral center of his brain, and was turning the rest of it into cottage cheese.
So does syphillis really do this? Can it destroy, for instance, the moral part of the brain, but leave motor and memory centers intact, or vice versa?
I’d say that is possible in theory, if you caught the guy during that window where his brain was still functioning on almost all cylinders. I don’t think syphillis is selective in where it attacks, so the swiss-cheesing of the guys brain could have begun with wherever his “moral center” was, without wrecking his motor skills. But it would be a very narrow window.
Ah, the infamous episode “Scourge,” with Karen Allen. That one really freaked me out. Perhaps you should have said “spoiler alert” or something in the thread title rather than just “TMI” – since, after all …
The fact that he has syphilis is one of the major bombshells of the episode.
As for whether syphilis can actually do that … I think the syphilis had damaged all of his brain, not just the frontal lobes (which control morality and restraint and that kind of thing). But the damage to the frontal lobes had basically caused him to lose all inhibitions, which was why he started killing people.
He did have other symptoms, though. IIRC, he had memory problems, he was in constant pain, and he seemed to be somewhat uncoordinated when he moved – maybe the actor just played him that way by accident, or maybe it was a deliberate attempt at simulating brain damage to the areas of his brain dealing with motor control … I guess we can’t know for sure, but to me it looked deliberate.
But the frontal lobe damage was the part that produced the biggest change, as it turned him into a psychopathic killer. I don’t know for sure, but I would think it’s entirely possible for syphilitic brain damage to produce symptoms like that. Other things that reduce inhibitions, like drinking for instance, don’t necessarily produce correspondingly huge problems with motor control or memory when they lower your inhibitions. At least not unless you drink more and more. If that makes sense … I hope what I mean is clear. If not, well, let me know and I’ll try to clarify.
I’m not a doctor, nurse, etc., but from what I’ve read, many types of brain injuriesand diseases can result in loss of inhibitions or other types of formerly atypical behavior. It’s not just syphillis.
The central nervous system damage caused by tertiary syphilis (occurring years after the original infection) goes beyond tabes dorsalis, which involves weakness, sensory changes and impaired coordination for the most part.
Behavioral changes fall under the heading of general paresis. Again according to the NIH: “The infection causes widespread damage to the nerves of the brain. This damage results in personality changes, mood changes, hyperactive reflexes, pain (“lightning pains,” brief sharp pains in all parts that are characteristic of tabes dorsalis), eye changes with abnormal pupil response, abnormal mental function including hallucinations and delusions, decreased intellectual functioning (memory, calculating, judgment, insight), and speech changes.”
So theoretically you could have a serial killer whose behavior is caused by tertiary syphilis.
You usually think of serial killers more as crafty sociopaths, though - not some lurching Al Capone-like figure who’s having hallucinations.
Tabes dorsalis is the locomotor variant of tertiary syphilis. Parenchymatous and meningovascular syphilis are the varities that attack the meninges of the brain and cause cerebral atrophy. This used to be called Total Paresis of the Insane (TPI) and was a common cause of institutionalisation before the advent of penicillin. Al Capone died in prison from his tertiary syphilis.
A lot of early jazz and ragtime musicians contracted syphilis in their early, rambling days, and died horribly years later. Scott Joplin died in an insane asylum in 1917, and he was only 49.
“Mad” King Ludwig of Bavaria also suffered from syphilis, IIRC, and he certainly was peculiar – he built the famous fairy-tale castes, including the spectacular Neuschwanstein, and died in a mysterious incident wherein he and his physican went walking, and both were found drowned a few days later.