Locomotor ataxia; Syphilitic myelopathy; Syphilitic myeloneuropathy; Myelopathy - syphilitic; Tabetic neurosyphilis DefinitionTabes dorsalis is a complication of untreated syphilis that involves muscle weakness and abnormal sensations. CausesTabes 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 may damage 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. SymptomsSymptoms of tabes dorsalis are caused by damage to the nervous system. Symptoms include any of the following:
Exams and TestsThe 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, more tests are done to confirm the diagnosis. TreatmentThe 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:
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 ComplicationsComplications may include:
When to Contact a Medical ProfessionalContact your provider if you have:
PreventionProper 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. ReferencesGhanem 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. | |
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Review Date: 9/10/2022 Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, 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. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 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 anteri...
Primary syphilis
Late-stage syphili
