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

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

Diagnostic testing:

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  Cerebrospinal (CSF) examination;

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  CT/MRI of the head and spine; and

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

Physical findings:

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  Myelopathy with characteristic high stepping “tabetic gait;”

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  Loss of coordination and balance;

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  Pupils that react abnormally to light;

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  Diminished (hyporeflexia) or absent (areflexia) reflexes;

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  Episodes of intense pain and disturbed sensation (paresthesias);

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  Personality changes;

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  Dementia;

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  Deafness; and

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  Visual impairment.

ICD-9: 094.0

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.

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

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for Evaluation:

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

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  Laboratory reports of cerebrospinal fluid; and

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

REMARKS