Tabes dorsalis

Pre speech: Tabes dorsalis is a degenerative disorder which is caused the proprioceptive sensory loss. It may be called sensory Neuron Disease (SND): as the sensory are affected.

Synonym:

1. Locomotor ataxia.

2. Syphilitic spinal sclerosis.

Definition: Tabes dorsalis is a slow degeneration of the sensory neurons caused by degenerating nerves are in the dorsal columns (posterior columns) of the spinal cord (the portion closest to the back of the body) and carry information that help maintain a person’s propiroception (sense of position) vibration and discriminative touch.

(Reference: DOVS, 7th edition)

Or,

A degenerative disease of the posterior columns of the spinal cord the posterior spinal nerve roots and the peripheral nerves accompanied by a number of ocular signs and symptoms such as atrophy of the optic nerve, visual field defects, ptosis, Argyll Robertson pupil and paralysis of one or more of the extra ocular muscles. The disease is a result of neurosyphillis.

(Reference: Dictionary of Optometry and Visual Science, 7th edition)

Incidence/Prevalence:

• Onset is common during mid life.

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

• Males are more affected than the females (Raito 4:1)

Cause: Tabes dorsalis is caused by demyelination. It is the result of an untreated syphilis infection.

Symptoms: Symptoms may not apper for some decades after the initial infection. Onset usually occurs during mid life. The most common symptoms of tabes dorslais are-

• Weakness.

• Diminished reflexes.

• Unsteady gait.

• Progressive degeneration of the joints.

• Loss of coordination.

• Episodes of intense pain and disturbed sensation.

• Personality changes.

• Dementia.

• Deafness.

• Visual impairment.

• Impaired response to light.

Prognosis

Left untreated, tabes dorsalis can lead to paralysis, dementia, and blindness. Existing nerve damage cannot be reversed.

Epidemiology

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, administered intravenously, is the treatment of choice. Associated pain can be treated with opiates, valproate, or carbamazepine. Patients may also require physical therapy to deal with muscle wasting and weakness. Preventive treatment for those who come into sexual contact with an individual with syphilis is important.