Tabes dorsalis
Syphilitic myelopathy is a complication of untreated syphilis that involves muscle weakness and abnormal sensations.
Syphilitic myelopathy is a form of neurosyphilis, which is a complication of late or tertiary syphilis infection. Syphilis is a sexually transmitted, infectious disease. For information on the disease, see: Syphilis.
The condition called tabes dorsalis includes syphilitic myelopathy and additional symptoms of nerve damage.
The infection damages the tissue of the spinal cord and peripheral nervous tissue. This causes decreased muscle function (myelopathy), including progressive weakness of the legs, arms, and other areas. Loss of function may eventually result in paralysis.
Coordination difficulties contribute to problems walking. There are often changes in sensation, including painful paresthesia (abnormal sensations), which are also referred to as "lightning pains."
In syphilitic myelopathy, the muscle problems are accompanied by other symptoms characteristic of nervous system damage caused by syphilis. These include vision changes, stroke, and psychiatric illness.
Syphilitic myelopathy is now very rare because syphilis is usually treated early in the disease or as a result of screening blood tests that identify the disease in its latent (silent) form. Such blood tests are performed, for example, on individuals who donate blood and during pregnancy.
Centers for Disease Control and Prevention (CDC). Recommendations and Reports: Sexually Transmitted Diseases. MMWR Morb Mortal Wkly Rep. 2006;55(RR-11).
U.S. Preventive Services Task Force. Screening for Syphilis Infection: Recommendation Statement. Ann Fam Med. 2004;2:362-365.
Hook EW III. Syphilis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 340.
Tremont EC. Treponema pallidum (Syphilis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2005: chap 235.