Syphilitic myelopathy
Alternative names:
tabes dorsalis - myelopathy
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.
Neurosyphilis: - aqueous penicillin G, 12 to 24 million units, injected into a vein(IV), daily for 10 days; followed by benzathine penicillin, 2.4 million units, once a week for 3 weeks
- procaine penicillin, 2.4 million units injected into a muscle (IM), once a day for 10 days; given with oral probenecid, 500 milligrams (mg) four times a day for 10 days. This is then followed by benzathine penicillin, 2.4 million units IM once a week for 3 weeks. (See penicillins - injectable).
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, and so on). Rehabilitation, physical therapy, occupational therapy, or other interventions may be appropriate for people with muscle weakness.
Analgesics may be required to control pain. This may include over-the-counter medications such as aspirin (see salicylates - oral), acetaminophen - oral, or ibuprofen if pain is mild. It may require narcotics (see Narcotic Analgesics - oral) to control severe pain.
Expectations (prognosis):
Progressive disability is possible if the disorder is left untreated. People with late syphilis infections are at greater risk for other infections and diseases.
Complications:
- inability to care for self
- inability to communicate or interact
- development of other forms of neurosyphilis
- 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, particularly if there is a known history of syphilis infection.
Picture:
P0558.pctScissors gait
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