Tabes Dorsalis medical therapy: Difference between revisions

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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]].
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 allergy|penicillin allergies]] may have to be desensitized to [[penicillin]] so that they can be safely treated with it.
[[Penicillin]] is the treatment of choice for [[neurosyphilis]], although it penetrates the blood brain barrier poorly.


For the treatment of neurosyphilis, treponemicidal levels of penicillin can be achieved in the CSF by one of the following methods for 21 to 28 days:
* Intramuscular injection of 2.4 million units procaine penicillin daily with concurrent probenecid 500 mg 4 times a day
* Or an intravenous infusion of benzyl penicillin 12-24 million units daily.
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 medicine|Rehabilitation]], [[physical therapy]], and occupational therapy may help people who have [[muscle weakness]].
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 medicine|Rehabilitation]], [[physical therapy]], and occupational therapy may help people who have [[muscle weakness]].



Revision as of 15:38, 7 February 2018

Tabes Dorsalis Microchapters

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Overview

Historical Perspective

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Differentiating Tabes Dorsalis from other Diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Penicillin, administered intravenously, is the treatment of choice. Associated pain can be treated with opiates, valproate, or carbamazepine. Patients may also require physical or rehabilitative therapy to deal with muscle wasting and weakness. Preventive treatment for those who come into sexual contact with an individual with tabes dorsalis is important.

Medical Therapy

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.

Penicillin is the treatment of choice for neurosyphilis, although it penetrates the blood brain barrier poorly.

For the treatment of neurosyphilis, treponemicidal levels of penicillin can be achieved in the CSF by one of the following methods for 21 to 28 days:

  • Intramuscular injection of 2.4 million units procaine penicillin daily with concurrent probenecid 500 mg 4 times a day
  • Or an intravenous infusion of benzyl penicillin 12-24 million units daily.

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.

One may need analgesics 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.

References

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