Tabes Dorsalis history and symptoms: Difference between revisions

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{{Tabes dorsalis}}
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==Overview==
A positive history of [[Unprotected sex|unprotected sexual activity]] or a proved treponemal infection in the setting of clinical manifestations is suggestive of tabes dorsalis. The most common symptoms of tabes dorsalis include lightning pains, impaired [[sensation]] and [[proprioception]], [[Hypesthesia|hypesthesias]], [[Hyporeflexia|diminished reflexes]] or [[Areflexia|loss of reflexes]], [[Poor coordination]] or loss of coordination, [[Unsteady gait]] ([[locomotor ataxia]]), s[[Sexual function|exual function]] problems and progressive [[sensory ataxia]] (inability to feel the [[lower limbs]]).


==History and Symptoms==
==History and Symptoms==
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, and formication (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 (including [[glossodynia]]), 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 as [[Westphal's sign]].
===History===
 
* Unprotected sexual activity
''Tabes dorsalgia'' is a related back pain.
* HIV infection
 
* [[Immunocompromised]] state
Common symptoms include
* [[Immunosuppressive therapy]]
*Abnormal sensations (paresthesia), often called "lightning pains"
* Substance abuse
*Difficulty walking
* Positive history of long-term untreated [[Syphilis|syphilis disease]]<ref name="pmid336144">{{cite journal| author=Kolar OJ, Burkhart JE| title=Neurosyphilis. | journal=Br J Vener Dis | year= 1977 | volume= 53 | issue= 4 | pages= 221-5 | pmid=336144 | doi= | pmc=1045401 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=336144  }} </ref>
*Loss of coordination
*Loss of reflexes
*Muscle weakness
*Wide-based gait (the person walks with the legs far apart)


In Tabes dorsalis, there are also symptoms of nervous system damage, including:
===Common Symptoms===
Common symptoms of tabes dorsalis include:
* Lightning pain<ref name="pmid19487174">{{cite journal| author=MAO S, LIU Z| title=Neurosyphilis manifesting as lightning pain. | journal=Eur J Dermatol | year= 2009 | volume= 19 | issue= 5 | pages= 504-6 | pmid=19487174 | doi=10.1684/ejd.2009.0712 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19487174  }} </ref>
*Impaired [[sensation]] and [[proprioception]]<ref name="pmid15224672">{{cite journal| author=Vora SK, Lyons RW| title=The medical Kipling--syphilis, tabes dorsalis, and Romberg's test. | journal=Emerg Infect Dis | year= 2004 | volume= 10 | issue= 6 | pages= 1160-2 | pmid=15224672 | doi=10.3201/eid1006.031117 | pmc=3323152 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15224672  }} </ref>
*[[Numbness]]<ref name="pmid22330117">{{cite journal| author=Pandey S| title=Magnetic resonance imaging of the spinal cord in a man with tabes dorsalis. | journal=J Spinal Cord Med | year= 2011 | volume= 34 | issue= 6 | pages= 609-11 | pmid=22330117 | doi=10.1179/2045772311Y.0000000041 | pmc=3237288 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22330117  }} </ref>
*Inability to feel the [[lower limbs]]<ref name="pmid27465246">{{cite journal| author=Sabre L, Braschinsky M, Taba P| title=Neurosyphilis as a great imitator: a case report. | journal=BMC Res Notes | year= 2016 | volume= 9 | issue=  | pages= 372 | pmid=27465246 | doi=10.1186/s13104-016-2176-2 | pmc=4964046 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27465246  }} </ref>
*[[Hyporeflexia|Diminished reflexes]] or [[Areflexia|loss of reflexes]]<ref name="pmid3358168">{{cite journal| author=Smikle MF, James OB, Prabhakar P| title=Diagnosis of neurosyphilis: a critical assessment of current methods. | journal=South Med J | year= 1988 | volume= 81 | issue= 4 | pages= 452-4 | pmid=3358168 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3358168  }} </ref>
*[[Poor coordination]] or loss of coordination<ref name="pmid22994551">{{cite journal| author=Mehrabian S, Raycheva M, Traykova M, Stankova T, Penev L, Grigorova O et al.| title=Neurosyphilis with dementia and bilateral hippocampal atrophy on brain magnetic resonance imaging. | journal=BMC Neurol | year= 2012 | volume= 12 | issue=  | pages= 96 | pmid=22994551 | doi=10.1186/1471-2377-12-96 | pmc=3517431 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22994551  }} </ref>
*[[Unsteady gait]] ([[locomotor ataxia]])<ref name="pmid8334567">{{cite journal| author=Gue JW, Wang SJ, Lin YY, Liao KK, Wong WW| title=Neurosyphilis presenting as tabes dorsalis in a HIV carrier. | journal=Zhonghua Yi Xue Za Zhi (Taipei) | year= 1993 | volume= 51 | issue= 5 | pages= 389-91 | pmid=8334567 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8334567  }} </ref>
*[[Sexual function]] problems<ref name="pmid22334859">{{cite journal| author=Ahamed S, Varghese M, El Agib el N, Ganesa VS, Aysha M| title=Case of neurosyphilis presented as recurrent stroke. | journal=Oman Med J | year= 2009 | volume= 24 | issue= 2 | pages= 134-6 | pmid=22334859 | doi=10.5001/omj.2009.29 | pmc=3273935 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22334859  }} </ref>


*Mental illness
===Less Common Symptoms===
*[[Stroke (patient information)|Stroke]]
Less common symptoms of tabes dorsalis include:
*Vision changes
*Degeneration of the joints ([[Charcot joint]]<nowiki/>s)<ref name="pmid23919113">{{cite journal| author=Kaynak G, Birsel O, Güven MF, Oğüt T| title=An overview of the Charcot foot pathophysiology. | journal=Diabet Foot Ankle | year= 2013 | volume= 4 | issue=  | pages=  | pmid=23919113 | doi=10.3402/dfa.v4i0.21117 | pmc=3733015 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23919113  }} </ref>
*[[Muscle weakness]]<ref name="pmid16778468">{{cite journal| author=Matijosaitis V, Vaitkus A, Pauza V, Valiukeviciene S, Gleizniene R| title=Neurosyphilis manifesting as spinal transverse myelitis. | journal=Medicina (Kaunas) | year= 2006 | volume= 42 | issue= 5 | pages= 401-5 | pmid=16778468 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16778468  }} </ref>
*Bladder control problems<ref name="pmid3761456">{{cite journal| author=Wheeler JS, Culkin DJ, O'Hara RJ, Canning JR| title=Bladder dysfunction and neurosyphilis. | journal=J Urol | year= 1986 | volume= 136 | issue= 4 | pages= 903-5 | pmid=3761456 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3761456  }} </ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Needs overview]]
[[Category:Neurology]]
[[Category:Pain]]


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[[Category: (name of the system)]]

Latest revision as of 19:38, 1 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

A positive history of unprotected sexual activity or a proved treponemal infection in the setting of clinical manifestations is suggestive of tabes dorsalis. The most common symptoms of tabes dorsalis include lightning pains, impaired sensation and proprioception, hypesthesias, diminished reflexes or loss of reflexes, Poor coordination or loss of coordination, Unsteady gait (locomotor ataxia), sexual function problems and progressive sensory ataxia (inability to feel the lower limbs).

History and Symptoms

History

Common Symptoms

Common symptoms of tabes dorsalis include:

Less Common Symptoms

Less common symptoms of tabes dorsalis include:

References

  1. ↑ Kolar OJ, Burkhart JE (1977). "Neurosyphilis". Br J Vener Dis. 53 (4): 221–5. PMC 1045401. PMID 336144.
  2. ↑ MAO S, LIU Z (2009). "Neurosyphilis manifesting as lightning pain". Eur J Dermatol. 19 (5): 504–6. doi:10.1684/ejd.2009.0712. PMID 19487174.
  3. ↑ Vora SK, Lyons RW (2004). "The medical Kipling--syphilis, tabes dorsalis, and Romberg's test". Emerg Infect Dis. 10 (6): 1160–2. doi:10.3201/eid1006.031117. PMC 3323152. PMID 15224672.
  4. ↑ Pandey S (2011). "Magnetic resonance imaging of the spinal cord in a man with tabes dorsalis". J Spinal Cord Med. 34 (6): 609–11. doi:10.1179/2045772311Y.0000000041. PMC 3237288. PMID 22330117.
  5. ↑ Sabre L, Braschinsky M, Taba P (2016). "Neurosyphilis as a great imitator: a case report". BMC Res Notes. 9: 372. doi:10.1186/s13104-016-2176-2. PMC 4964046. PMID 27465246.
  6. ↑ Smikle MF, James OB, Prabhakar P (1988). "Diagnosis of neurosyphilis: a critical assessment of current methods". South Med J. 81 (4): 452–4. PMID 3358168.
  7. ↑ Mehrabian S, Raycheva M, Traykova M, Stankova T, Penev L, Grigorova O; et al. (2012). "Neurosyphilis with dementia and bilateral hippocampal atrophy on brain magnetic resonance imaging". BMC Neurol. 12: 96. doi:10.1186/1471-2377-12-96. PMC 3517431. PMID 22994551.
  8. ↑ Gue JW, Wang SJ, Lin YY, Liao KK, Wong WW (1993). "Neurosyphilis presenting as tabes dorsalis in a HIV carrier". Zhonghua Yi Xue Za Zhi (Taipei). 51 (5): 389–91. PMID 8334567.
  9. ↑ Ahamed S, Varghese M, El Agib el N, Ganesa VS, Aysha M (2009). "Case of neurosyphilis presented as recurrent stroke". Oman Med J. 24 (2): 134–6. doi:10.5001/omj.2009.29. PMC 3273935. PMID 22334859.
  10. ↑ Kaynak G, Birsel O, Güven MF, Oğüt T (2013). "An overview of the Charcot foot pathophysiology". Diabet Foot Ankle. 4. doi:10.3402/dfa.v4i0.21117. PMC 3733015. PMID 23919113.
  11. ↑ Matijosaitis V, Vaitkus A, Pauza V, Valiukeviciene S, Gleizniene R (2006). "Neurosyphilis manifesting as spinal transverse myelitis". Medicina (Kaunas). 42 (5): 401–5. PMID 16778468.
  12. ↑ Wheeler JS, Culkin DJ, O'Hara RJ, Canning JR (1986). "Bladder dysfunction and neurosyphilis". J Urol. 136 (4): 903–5. PMID 3761456.

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