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Tabes dorsalis

Show Alternative Names
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:

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

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:

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.

Text only

Review Date: 10/25/2020

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, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

Ghanem KG, Hook EW. Syphilis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 303.

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. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 237.

Disclaimer

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., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Superficial anterior muscles - Illustration Thumbnail

Superficial anterior muscles

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

Illustration

Primary syphilis - Illustration Thumbnail

Primary syphilis

Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum. Primary syphilis presents as a small painless open sore 3 to 6 weeks after exposure. Although the lesion heals within 6 to 8 weeks, the untreated organism will continue to multiply unchecked, causing many complications. Infection may last for 30 years or more and result in severe neurological complications.

Illustration

Late-stage syphilis - Illustration Thumbnail

Late-stage syphilis

Tertiary syphilis is a late stage of the disease which can follow the initial infection, primary syphilis, by several years. Pockets of damage accumulate in various tissues such as the bones, skin, nervous tissue, heart, and arteries. These lesions are called gummas and are very destructive.

Illustration

Superficial anterior muscles - Illustration Thumbnail

Superficial anterior muscles

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

Illustration

Primary syphilis - Illustration Thumbnail

Primary syphilis

Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum. Primary syphilis presents as a small painless open sore 3 to 6 weeks after exposure. Although the lesion heals within 6 to 8 weeks, the untreated organism will continue to multiply unchecked, causing many complications. Infection may last for 30 years or more and result in severe neurological complications.

Illustration

Late-stage syphilis - Illustration Thumbnail

Late-stage syphilis

Tertiary syphilis is a late stage of the disease which can follow the initial infection, primary syphilis, by several years. Pockets of damage accumulate in various tissues such as the bones, skin, nervous tissue, heart, and arteries. These lesions are called gummas and are very destructive.

Illustration

 
 
 
 

 

 
 

 
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