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Syphilitic myelopathy

  • Alternative Names

    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

    Signs and tests

    Physical examination may show:

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

    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