Tabes dorsalis

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Tabes dorsalis
Synonyms	Tabes spinalis, locomotor ataxia
Pronounce	N/A
Specialty	N/A
Symptoms	Ataxia, paresthesia, urinary incontinence, loss of reflexes, Argyll Robertson pupil
Complications	Charcot joint, neurogenic bladder, optic atrophy
Onset	10 to 30 years after initial syphilis infection
Duration	Chronic
Types	N/A
Causes	Tertiary syphilis
Risks	Untreated syphilis infection
Diagnosis	Serology, lumbar puncture
Differential diagnosis	Multiple sclerosis, Friedreich's ataxia, peripheral neuropathy
Prevention	N/A
Treatment	Antibiotics (e.g., penicillin), symptomatic treatment
Medication	N/A
Prognosis	Variable, depends on stage and treatment
Frequency	Rare in developed countries
Deaths	N/A

Tabes Dorsalis is a serious and specific form of neurosyphilis, an infection of the nervous system by the bacterium Treponema pallidum. This condition is characterized by the slow but progressive degeneration of the sensory neurons in the dorsal columns of the spinal cord, leading to a range of neurological symptoms.

Introduction

Tabes Dorsalis typically develops in the later stages of untreated syphilis, often years after the initial infection. The degeneration of spinal cord neurons particularly affects the sensory pathways, resulting in a variety of symptoms.

Pathophysiology

Tabes dorsalis is a slow degeneration of the nerve cells and nerve fibers that carry sensory information to the brain. The degenerating nerves are in the dorsal columns of the spinal cord (the portion closest to the back of the body) and carry information that help maintain a person's sense of position.

Cause

Tabes dorsalis is the result of an untreated syphilis infection.

Signs and symptoms

Signs and symptoms include pain, ataxia, loss of coordination, personality changes, blindness, urinary incontinence, dementia, and degeneration of the joints. Symptoms may not appear for some decades after the initial infection.

Syphilitic depression of the nasal bone

Sex distribution

The disease is more frequent in males than in females.

Onset

Onset is commonly during mid-life.

Association with HIV

The incidence of tabes dorsalis is rising, in part due to co-associated HIV infection.

Symptoms and Signs

Common symptoms of Tabes Dorsalis include:

• Severe pain in the legs and back
• Muscle weakness and loss of coordination (ataxia)
• Sensory impairment leading to loss of reflexes
• Gastrointestinal disturbances
• Bladder dysfunction

Pathophysiology

The damage in Tabes Dorsalis results from the destruction of the myelin sheath that surrounds and protects nerve fibers in the spinal cord. This demyelination disrupts normal sensory transmission.

Diagnosis

Diagnosis of Tabes Dorsalis involves:

• Clinical evaluation of symptoms
• Serological tests for syphilis
• Neurological examination
• Imaging studies like MRI

Treatment

Treatment for Tabes Dorsalis focuses on:

• Antibiotic therapy to treat the underlying syphilis infection
• Symptomatic treatment to manage pain and muscle weakness
• Physical therapy to improve muscle function and coordination

Prevention

Prevention of Tabes Dorsalis largely depends on the early detection and treatment of syphilis.

See Also

• Neurosyphilis
• Spinal Cord
• Infectious Diseases

External Links

• CDC: Syphilis - STD Facts
• World Health Organization: Syphilis Fact Sheet