目的探讨以精神症状为首发的神经梅毒临床特征及诊断要点。方法对32例神经梅毒患者的临床资料进行回顾性分析。结果以精神症状为首发的神经梅毒逐年上升,并有年轻化趋势;因其临床症状多变复杂,无特征性,极易误诊为功能性精神障碍。结论掌握神经梅毒的临床特征性症状、详细采集病史、完善体格检查及实验室筛查是减少误诊率的关键。 Objective To investigate the clinical features and diagnosis of neurosyphilis with psychiatric symptoms as its first step. Methods The clinical data of 32 patients with neurosyphilis were retrospectively analyzed. Results The onset of neurological syphilis with psychiatric symptoms increased year by year with younger tendency. Because of its complicated clinical features and no characteristic, it is easily misdiagnosed as functional mental disorder. Conclusion To master the clinical symptoms of neurosyphilis, collect detailed medical history, improve physical examination and laboratory screening is the key to reduce the rate of misdiagnosis.