Syphilitic myelopathy

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Superficial anterior muscles

Locomotor ataxia

The goals of treatment are to cure the infection and slow the progression of the disorder. Treating the infection helps prevent new nerve damage and may reduce symptoms, but it does not reverse existing nerve damage.

For neurosyphilis, aqueous penicillin G (by injection) is the drug of choice. Some patients with penicillin allergies may have to be desensitized to penicillin so that they can be safely treated with it.

Symptoms of existing neurologic 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 people who have muscle weakness.

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You may needanalgesics to control pain. These may include over-the-counter medications such as aspirin or acetaminophen for mild pain, or narcotics for more severe pain. Anti-epilepsy drugs such as carbamazepine may help treat lightning pains.

Progressive disability is possible if the disorder is left untreated.

• Complications of late-stage syphilis infection, which may include:
  • Inflammation of the aorta (aortitis) with aortic aneurysm
  • Disease of the heart valves
  • Damage to bones, skin, and other organs
• Complications of neurosyphilis, including dementia, stroke, eye disease
• Difficulty with walking and balance
• Paralysis

Call your health care provider if you have:

• Loss of coordination
• Loss of muscle strength
• Loss of sensation

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).