Locations Main Campus: Chesterfield, MO 63017   |   Locations
314-434-1500 314-434-1500   |   Contact Us

Multimedia Encyclopedia


 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

Tabes dorsalis

Locomotor ataxia; Syphilitic myelopathy; Syphilitic myeloneuropathy; Myelopathy - syphilitic; Tabetic neurosyphilis

 

Tabes dorsalis is a complication of untreated syphilis that involves muscle weakness and abnormal sensations.

Causes

 

Tabes dorsalis is a form of neurosyphilis, which is a complication of late stage syphilis infection. Syphilis is a bacterial infection that is spread sexually.

When syphilis is untreated, the bacteria damages the spinal cord and peripheral nervous tissue. This leads to the symptoms of tabes dorsalis.

Tabes dorsalis is now very rare because syphilis is usually treated early in the disease.

 

Symptoms

 

Symptoms of tabes dorsalis are caused by damage to the nervous system. Symptoms include any of the following:

  • Abnormal sensations (paresthesia), often called "lightning pains"
  • Problems walking such as with the legs far apart
  • Loss of coordination and reflexes
  • Joint damage, especially of the knees
  • Muscle weakness
  • Vision changes
  • Bladder control problems
  • Sexual function problems

 

Exams and Tests

 

The health care provider will perform a physical exam, focusing on the nervous system.

If syphilis infection is suspected, tests may include the following:

  • Cerebrospinal fluid (CSF) examination
  • Head CT, spine CT, or MRI scans of the brain and spinal cord to rule out other diseases
  • Serum VDRL or serum RPR (used as a screening test for syphilis infection)

If the serum VDRL or serum RPR test is positive, one of the following tests will be needed to confirm the diagnosis:

  • FTA-ABS
  • MHA-TP
  • TP-EIA
  • TP-PA

 

Treatment

 

The goals of treatment are to cure the infection and slow the disease. Treating the infection helps prevent new nerve damage and may reduce symptoms. Treatment does not reverse existing nerve damage.

Medicines likely to be given include:

  • Penicillin or other antibiotics for a long time to make sure the infection goes away
  • Painkillers to control pain

Symptoms of existing nervous system damage need to be treated. People who are unable to eat, dress themselves, or take care of themselves may need help. Rehabilitation, physical therapy, and occupational therapy may help with muscle weakness.

 

Outlook (Prognosis)

 

Left untreated, tabes dorsalis may lead to disability.

 

Possible Complications

 

Complications may include:

  • Blindness
  • Paralysis

 

When to Contact a Medical Professional

 

Call your provider if you have:

  • Loss of coordination
  • Loss of muscle strength
  • Loss of sensation

 

Prevention

 

Proper treatment and follow-up of syphilis infections reduces the risk of developing tabes dorsalis.

If you are sexually active, practice safer sex and always use a condom.

All pregnant women should be screened for syphilis.

 

 

References

Hook EW. Syphilis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 319.

Radolf JD,Tramont EC, Salazar JC. Syphilis (Treponema pallidum). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 239.

 
  • Superficial anterior muscles

    Superficial anterior muscles - illustration

    Superficial muscles are close to the surface of the skin. Muscles which lie closer to bone or internal organs are called deep muscles.

    Superficial anterior muscles

    illustration

    • Superficial anterior muscles

      Superficial anterior muscles - illustration

      Superficial muscles are close to the surface of the skin. Muscles which lie closer to bone or internal organs are called deep muscles.

      Superficial anterior muscles

      illustration


     

    Review Date: 7/31/2016

    Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

    The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
    adam.com

     
     
     

     

     

    A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.



    Content is best viewed in IE9 or above, Firefox and Google Chrome browser.