Superficial anterior muscles
Superficial anterior muscles


Syphilitic myelopathy

Alternative Names:
Tabes dorsalis

Treatment:

The goals of treatment are to cure the infection and to reduce progression of the disorder. Treatment of the infection reduces new nerve damage and may reduce symptoms but does not cure existing nerve damage.

For neurosyphilis, aqueous penicillin G (by injection) is the drug of choice. Some patients with penicillin allergies are desensitized to penicillin so that it can be used to treat this disease.

Symptomatic treatment is required for existing neurologic damage. Assistance or supervision may be needed if the person is unable to perform self-care activities (eating, dressing, etc.). Rehabilitation, physical therapy, occupational therapy, or other interventions may be appropriate for people with muscle weakness.

Analgesics may be required to control pain. These may include over-the-counter medications such as aspirin (oral salicylates) or acetaminophen for mild pain but narcotics may be required. Anti-epilepsy drugs such as carbamazepine may have a role in the treatment of lightning pains.



Expectations (prognosis):
Progressive disability is possible if the disorder is left untreated.

Complications:
  • Difficulty with walking and balance
  • Other complications of neurosyphilis: dementia, strokes, eye disease
  • Other complications of late-stage syphilis infection


Calling your health care provider:

Call your health care provider if loss of coordination, loss of muscle strength, or loss of sensation occurs.




Review Date: 8/7/2002
Reviewed By: Camille Kotton, M.D., Infectious Diseases Division, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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