To the Editor.—Dr. Karl Ekbom has reported on the beneficial effect of carbamazepine in the treatment of tabetic lightning pains.1 We have experience with 241 patients with neurosyphilis,2 six of whom suffered from tabetic lightning pains. The symptoms and signs among our patients were similar to the patients studied by Dr. Ekbom. The decreased and delayed perception of deep pain was the major sign in all cases.
All six patients had successful treatment with 20 million units of penicillin G, administered intramuscularly, over a period of three weeks, as well as the administration of atropine orally (1.2 mg/day). These patients had previously been receiving small doses of penicillin G in the range of 6 to 10 million units without success. In addition, four of them had received malaria therapy, bismuth sodium tartrate and arsenic trioxide, without success. One to four years' follow-up after treatment with penicillin G
HOOSHMAND H. Tabetic Lightning Pains. Arch Neurol. 1973;28(1):70. doi:10.1001/archneur.1973.00490190088015
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