Tabes dorsalis,, also called Progressive Locomotor Ataxia, rare neurologic form of tertiary syphilis, involving sensory deficits, loss of neuromuscular. Tabes dorsalis is a slowly progressive parenchymatous degenerative disease involving the posterior columns (ie, demyelination) and posterior roots (ie, inflammatory change with fibrosis) of the spinal cord. The NINDS supports and conducts research on neurodegenerative disorders, such as tabes dorsalis, in an effort to find ways to prevent, treat.


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Tabes dorsalis Merritt's review, papilledema was frequently present resulting from acute hydrocephalus associated with meningeal inflammation with increased ICP. Papilledema is not a common finding today. The meningeal symptoms tabes dorsalis develop within 1 or 2 years of the initial infection.

Examination of the CSF in cases of syphilitic meningitis reveals an increased opening pressure, a lymphocytic pleocytosis, a normal or slightly decreased glucose concentration, an elevated protein concentration, and a positive VDRL test.

Tabes dorsalis - Wikipedia

Cerebral angiography may demonstrate a nonspecific pattern of diffuse tabes dorsalis of intracerebral arteries and arterioles. Neuroimaging may demonstrate multiple areas of tabes dorsalis.

The peak incidence for the development of meningovascular syphilis is 5 to 7 years after the primary infection. Syphilitic arteritis can also develop in any intraspinal artery, resulting in acute transverse myelitis with paraplegia, sensory level, and loss tabes dorsalis sphincter control.

Dementia paralytica is manifest as a slow deterioration in cognitive functioning with impaired memory, loss of insight and judgment, language abnormalities, loss of appendicular strength, tremor of the tongue and hands, pupillary abnormalities, and loss of bowel and bladder control.

Tabes dorsalis

The syndrome of dementia paralytica typically occurs 10 to 20 years after primary infection. Tabes dorsalis of the CSF at this stage demonstrates one or a combination of the following: Tabes dorsalis is characterized by paresthesias or dysesthesias in a radicular distribution.

As the disease progresses, proprioceptive and vibratory sense is lost due tabes dorsalis neuronal degeneration and infiltration of inflammatory cells into the dorsal columns and posterior spinal nerve roots of the spinal cord.


The peak incidence for tabes dorsalis is 15 to 20 years after the primary infection. It has been suggested tabes dorsalis the lancinating pains typically attributed to tabes dorsalis in the past were due to the heavy metal therapy used to treat neurosyphilis in the preantibiotic era and not the primary infection.

Gummatous neurosyphilis is characterized by gummata located in the basal cisterns, leptomeninges, tabes dorsalis within the parenchyma.

They produce focal neurological deficits and tabes dorsalis nerve palsies by exerting pressure on adjacent structures.

The nontreponemal tests in routine use today include the VDRL and the rapid plasma reagin test.

The VDRL test may be quantitated by serial dilutions of serum, and the titer tabes dorsalis reported as the greatest serum dilution that produces a positive result. The VDRL titer reaches low levels in late syphilis and may eventually become nonreactive.

An alternative regimen is procaine penicillin, 2.

Tabes dorsalis - an overview | ScienceDirect Topics

The skeletal musculature is hypotonic tabes dorsalis to destruction of the sensory limb of the spindle reflex. The deep tendon reflexes are also diminished or absent; for example, the "knee jerk" or patellar reflex may be lacking Westphal's sign.

A complication of tabes dorsalis can be transient neuralgic paroxysmal pain affecting the eyes and the ophthalmic areas, previously called "Pel's crises" after Dutch physician P. Now more commonly called "tabetic ocular crises", an attack is characterized by sudden, intense eye pain, tearing of the eyes and sensitivity to light.

In daylight the person can avoid some unsteadiness by watching their own feet. Cause[ edit ] Tabes dorsalis is caused by demyelination by advanced syphilis infection tertiary syphiliswhen the primary infection by the causative spirochete bacteriumTreponema pallidumis left tabes dorsalis for an extended period of time past the point of blood infection tabes dorsalis the organism.

The spirochete invades large myelinated fibers, leading to the involvement of the dorsal column medial leminiscus pathway rather than the spinothalamic tract.

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