ALTERNATE NAMES

Locomotor Ataxia; Progressive Locomotor Ataxia; Syphilitic Myelopathy; Syphilitic Spinal Sclerosis

DESCRIPTION

Tabes dorsalis is a complication of untreated syphilis that damages the spinal cord and peripheral nerves.

DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM/ICD-10-CM CODING

Diagnostic testing:

• •

  Cerebrospinal fluid (CSF) examination;

• •

  Computed tomography (CT)/magnetic resonance imaging (MRI) of the head and spine; and

• •

  Serum tests for syphilis infection are required to confirm the diagnosis.

Physical findings:

• •

  Myelopathy with characteristic high stepping “tabetic gait;”

• •

  Loss of coordination and balance;

• •

  Pupils that react abnormally to light;

• •

  Diminished (hyporeflexia) or absent (areflexia) reflexes;

• •

  Episodes of intense pain and disturbed sensation (paresthesias);

• •

  Personality changes;

• •

  Dementia;

• •

  Deafness; and

• •

  Visual impairment.

ICD-9: 094.0

ICD-10: A52.11

PROGRESSION

If left untreated, tabes dorsalis can lead to paralysis, dementia, and blindness, as well as affecting other body systems (for example, cardiovascular and musculoskeletal). Treating syphilis with antibiotics cures the infection and prevents new damage, but does not reverse the already present nerve degeneration and other complications.

TREATMENT

Physical and occupational therapy may help individuals who have muscle weakness or muscle wasting. Medications may be needed to treat associated pain.

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for Evaluation:

• •

  Clinical history and examination that describes the diagnostic features of the impairment and evidence of damage of the spinal cord and peripheral nervous tissue;

• •

  Laboratory reports of CSF; and

• •

  Head CT, spine CT, or MRI scans of the brain and spinal cord to rule out other diseases.

Suggested Listings for Evaluation:

DETERMINATION

LISTING

REMARKS

Meets

2.02

2.03

2.04

11.08

11.17

12.02

Equals

11.08

11.17