Thanks to Amy Wu for an interesting case of neurosyphilis!

Learning Points
-Tabes Dorsalis is a uncommon condition of slow demyelination of the posterior columns of the spinal cord caused by Treponema pallidum and is most commonly characterized by sensory ataxia and lancinating pains in the limbs.
-Although neurosyphilis is uncommon in the antibiotic era, it can occur at any time after initial infection and requires a high level of suspicion in symptomatic patients, particularly those with HIV.
-Treatment includes 10-14 days of IV penicillin G with serial monitoring of CSF until WBC is normal and VDRL is nonreactive.

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