Syphilitic myelopathy

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Superficial anterior muscles

Locomotor ataxia

• Abnormal sensations (paresthesia), often called "lightning pains"
• Difficulty walking
• Loss of coordination
• Loss of reflexes
• Muscle weakness
• Wide-based gait (the person walks with the legs far apart)

In syphilitic myelopathy, there are also symptoms of nervous system damage, including:

• Mental illness
• Stroke
• Vision changes

Physical examination may show:

• Damage to the spinal cord (myelopathy)
• Pupils that react abnormally to light
• Reduced or absent reflexes due to nerve damage

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Tests may include the following:

• CSF (cerebrospinal fluid) examination
• Head CT , spine CT , or MRI scans of the brain and spinal cord to rule out other diseases
• Serum VDRL or serum RPR (used as a screening test for syphilis infection -- if it is positive, one of the following tests will be needed to confirm the diagnosis):
  • FTA-ABS
  • MHA-TP

Review Date: 08/30/2010
Reviewed By: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Jatin Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).