- Tabes dorsalis
Infobox_Disease
Name = PAGENAME
Caption =
DiseasesDB = 29061
ICD10 = ICD10|A|52|1|a|50
ICD9 = ICD9|094.0
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj = neuro
eMedicineTopic = 684
MeshID = D013606Tabes dorsalis is a slow degeneration of the
nerve cell s and nerve fibers that carry sensory information to thebrain . The degenerating nerves are in thedorsal columns of thespinal cord (the portion closest to the back of the body) and carry information that help maintain a person's sense of position, vibration, and discriminative touch.Cause
Tabes dorsalis is caused by demyelination. It is the result of an untreated
syphilis infection.ymptoms
Symptoms may not appear for some decades after the initial infection and include:
weakness , diminished reflexes, paresthesias including morbid cutaneous sensations having no objective cause, shooting and burning pains, pricking sensations, andformication (a sensation like that produced by small insects crawling over skin), and hypesthesias (abnormally diminished cutaneous, especially tactile, sensory modalities), unsteady gait (locomotor ataxia ), progressive degeneration of the joints,loss of coordination , episodes of intense pain and disturbed sensation (includingglossodynia ),personality changes ,dementia ,deafness ,visual impairment , and impaired response to light. The skeletal musculature is hypotonic due 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, a characteristic finding in tabes known asWestphal's sign ."Tabes dorsalgia" is a related back pain.
Prognosis
If left untreated, tabes dorsalis can lead to
paralysis ,dementia , andblindness . Existing nerve damage cannot be reversed.Incidence/Prevalence
The disease is more frequent in males than in females. Onset is commonly during mid-life. The incidence of tabes dorsalis is rising, in part due to co-associated
HIV infection.Treatment
Penicillin , administeredintravenous ly, is the treatment of choice. Associated pain can be treated withopiate s,valproate , orcarbamazepine . Patients may also require physical orrehabilitative therapy to deal with muscle wasting and weakness. Preventive treatment for those who come into sexual contact with an individual with tabes dorsalis is important.Trivia
Sir Arthur Conan Doyle , author of theSherlock Holmes stories, completed hisdoctorate on tabes dorsalis in 1885.ee also
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General paresis of the insane References
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* [http://hdl.handle.net/1842/418 'An Essay Upon the Vasomotor Changes in Tabes Dorsalis' by Arthur Conan Doyle]
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