Tabes Dorsalis (Progressive Locomotor Ataxia, Syphilitic Spinal Sclerosis)

What is Tabes Dorsalis?

Tabes dorsalis is a degenerative condition that affects the nerve cells in the spinal cord’s dorsal columns. It affects the delivery of signals to and from the brain and results from untreated syphilis infection. It can take many years after infection for symptoms to become apparent. Males are more commonly affected than females.

Causes of tabes dorsalis

Tabes dorsalis is caused by syphilis infection that has been left untreated. Tabes dorsalis can develop as a complication of syphilis. In this case, the spinal cord is damaged and the nerve cells that carry information aren’t able to function properly. As a result, muscle function is impaired and this causes progressive weakness and even paralysis.

Often, symptoms of tabes dorsalis do not develop for many years after syphilis infection. Most commonly, symptoms become apparent in middle age.

What are the symptoms?

Symptoms of tabes dorsalis include:

  • difficulty with walking
  • lack of coordination
  • bouts of severe pain
  • loss of reflexes
  • muscle weakness
  • loss of vision
  • hearing problems
  • heightened sensitivity to light
  • changes in personality

Diagnosing tabes dorsalis

A physical examination will usually reveal a lack of reflexes (areflexia and further tests can be used to confirm a diagnosis. Additional tests may include a CT scan, analysis of the cerebrospinal fluid and serum RPR, which is used to detect syphilis infection.

How is tabes dorsalis treated?

The priority is to treat syphilis infection using intravenous penicillin. If the nerves have already been damaged, assistive therapies such as physiotherapy and occupational therapy may be recommended. Pain relief medication may also be prescribed.

What is the outlook?

With early treatment, tabes dorsalis can be treated effectively. However, if it left untreated, it can result in loss of vision, dementia and paralysis.

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