TABES DORSALIS

ALTERNATE NAMES

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

DESCRIPTION

Tabes Dorsalis is a complication of untreated syphilis that damages the spinal cord and peripheral nerves. Symptoms may not appear for many years after the initial infection and include weakness, diminished reflexes, unsteady gait, and loss of coordination, episodes of intense pain and disturbed sensation (paresthesias), personality changes, dementia, deafness, and visual impairment.

DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM CODING

Diagnostic testing: Cerebrospinal (CSF) examination, CT/MRI of the head and spine, and serum tests for syphilis infection are required to confirm the diagnosis.

Physical findings: Diagnostic testing along with physical examination may show evidence of damage to the spinal cord and myelopathy with characteristic high stepping “tabetic gait” with loss of coordination and balance, pupils that react abnormally to light, and reduced or absent reflexes.

ICD-9: 094.0

ONSET AND PROGRESSION

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.

TREATMENT

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:

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

• Laboratory reports of cerebrospinal fluid

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

Suggested Listings for Evaluation:

DETERMINATION

LISTING

Meets Listing

2.02

2.03

2.04

11.08

11.17

12.02

Medical Equals

11.08

11.17