My question is regarding the possibility of having neurosyphilis in the absence of any positive serologic tests. I have had a variety of tests from nontrep, trep specific and even LP with CSF-VDRL. All negative but with elevated spinal protein and liver enzymes, pupilary asymmetry, cardiac arrythmia, muscle fasciculations and extreme weakness, etc there continues to be concern. I understand that most MDs in the US do not support this possibility but I have come across research articles that do. What is your position on this issue. I did have a risky sexual encounter many years ago and am a gay male. Had a workup for everything under the sun including MS, heavy metals, Lou Gehrig's, EMG/NCV, CT scan all of which were negative. I do have dermatologic symptoms in the perineal area which clear when on antibiotics or when given corticosteroids but return when not using them. I have been seen by every specialist possible with no answer and no where to go.