The goals of treatment are to cure the infection and to reduce progression of the disorder. Treatment of the infection reduces new nerve damage and may reduce symptoms but does not cure existing nerve damage.
For neurosyphilis, aqueous penicillin G (by injection) is the drug of choice. Some patients with penicillin allergies are desensitized to penicillin so that it can be used to treat this disease.
Symptomatic treatment is required for existing neurologic damage. Assistance or supervision may be needed if the person is unable to perform self-care activities (eating, dressing, etc.). Rehabilitation, physical therapy, occupational therapy, or other interventions may be appropriate for people with muscle weakness.
Analgesics may be required to control pain. These may include over-the-counter medications such as aspirin (oral salicylates) or acetaminophen for mild pain but narcotics may be required. Anti-epilepsy drugs such as carbamazepine may have a role in the treatment of lightning pains.
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