Tabes Dorsalis differential diagnosis: Difference between revisions

Latest revision as of 17:02, 13 March 2019

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

Overview

Tabes dorsalis must be differentiated from other diseases that cause lightning pains, impaired sensation, ataxia and unsteady gait, such as vitamin B12 deficiency, extrinsic spinal cord compression, vitamin E deficiency and multiple sclerosis.

Differentiating tabes dorsalis from other Diseases

Tabes dorsalis must be differentiated from other diseases that cause lightning pains, impaired sensation and proprioception, and progressive sensory ataxia and unsteady gait (locomotor ataxia) and sexual function problems, such as vitamin B12 deficiency, extrinsic spinal cord compression, vitamin E deficiency and multiple sclerosis.^[1]^[2]^[3]^[4]

Diseases	History and symptoms				Physical examination				Laboratory findings	Other findings
Diseases	Lightning pains	Impaired sensation	Progressive sensory ataxia	Unsteady gait	Argyll-Robertson pupils	Impaired vibratory and proprioception sense	Broad base and sensory ataxic gait	Positive Romberg's test	Laboratory findings	Other findings
Tabes dorsalis	++	++	++	++	++	++	++	++	Positive VDRL Rapid plasma reagent FTA-ABS tests	-
B12 deficiency	+/-	+	+	+/-	+/-	++	+	+/-	Megaloblastic anemia, Low plasma methylmalonic acid level	Gastrointestinal symptoms Glossitis
Spinal cord compression	+/-	+/-	+/-	+/-	-	+/-	+/-	-	-	May be acute, subacute or chronic
Vitamin E deficiency	+/-	+	+	+/-	-	+/-	-	-	Hemolytic anemia	Muscle Weakness Retinopathy
Multiple sclerosis	+/-	+/-	+/-	+/-	Very rare	+/-	-	+/-	Oligoclonal bands of IgG on electrophoresis of cerebrospinal fluid	Vision problems Balance problems Dizziness Areas of demyelination in CNS MRI

References

↑ Clarke MW, Burnett JR, Croft KD (2008). "Vitamin E in human health and disease". Crit Rev Clin Lab Sci. 45 (5): 417–50. doi:10.1080/10408360802118625. PMID 18712629.
↑ Ribas ES, Schiff D (2012). "Spinal cord compression". Curr Treat Options Neurol. 14 (4): 391–401. doi:10.1007/s11940-012-0176-7. PMID 22547256.
↑ Oh R, Brown DL (2003). "Vitamin B12 deficiency". Am Fam Physician. 67 (5): 979–86. PMID 12643357.
↑ Goldenberg MM (2012). "Multiple sclerosis review". P T. 37 (3): 175–84. PMC 3351877. PMID 22605909.

[pmid18712629-1] Clarke MW, Burnett JR, Croft KD (2008). "Vitamin E in human health and disease". Crit Rev Clin Lab Sci. 45 (5): 417–50. doi:10.1080/10408360802118625. PMID 18712629.

[pmid22547256-2] Ribas ES, Schiff D (2012). "Spinal cord compression". Curr Treat Options Neurol. 14 (4): 391–401. doi:10.1007/s11940-012-0176-7. PMID 22547256.

[pmid12643357-3] Oh R, Brown DL (2003). "Vitamin B12 deficiency". Am Fam Physician. 67 (5): 979–86. PMID 12643357.

[pmid22605909-4] Goldenberg MM (2012). "Multiple sclerosis review". P T. 37 (3): 175–84. PMC 3351877. PMID 22605909.

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[2]

[3]

[4]

@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Tabes dorsalis}}
+[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Tabes_Dorsalis]]
+{{CMG}}; {{AE}}{{MMJ}}
-__NOTOC__
-{{xyz}}
-{{CMG}}; {{AE}}
 ==Overview==
-[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
+Tabes dorsalis must be differentiated from other diseases that cause lightning pains, impaired sensation, [[ataxia]] and [[unsteady gait]], such as [[vitamin B12 deficiency]], [[Spinal cord compression|extrinsic spinal cord compression]], [[vitamin E deficiency]] and [[multiple sclerosis]].
-OR
-[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
 ==Differentiating tabes dorsalis from other Diseases==
-*Tabes dorsalis must be differentiated from other diseases that cause lightning pains, impaired [[sensation]] and [[proprioception]], and progressive [[sensory ataxia]] and [[unsteady gait]]([[locomotor ataxia]]) and [[Sexual function]] problems, such as [[vitamin B12 deficiency]], extrinsic [[spinal cord compression]], [[vitamin E deficiency]] and [[multiple sclerosis]].
+*Tabes dorsalis must be differentiated from other diseases that cause lightning pains, impaired [[sensation]] and [[proprioception]], and progressive [[sensory ataxia]] and [[unsteady gait]] ([[locomotor ataxia]]) and [[sexual function]] problems, such as [[vitamin B12 deficiency]], extrinsic [[spinal cord compression]], [[vitamin E deficiency]] and [[multiple sclerosis]].<ref name="pmid18712629">{{cite journal| author=Clarke MW, Burnett JR, Croft KD| title=Vitamin E in human health and disease. | journal=Crit Rev Clin Lab Sci | year= 2008 | volume= 45 | issue= 5 | pages= 417-50 | pmid=18712629 | doi=10.1080/10408360802118625 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18712629  }} </ref><ref name="pmid22547256">{{cite journal| author=Ribas ES, Schiff D| title=Spinal cord compression. | journal=Curr Treat Options Neurol | year= 2012 | volume= 14 | issue= 4 | pages= 391-401 | pmid=22547256 | doi=10.1007/s11940-012-0176-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22547256  }} </ref><ref name="pmid12643357">{{cite journal| author=Oh R, Brown DL| title=Vitamin B12 deficiency. | journal=Am Fam Physician | year= 2003 | volume= 67 | issue= 5 | pages= 979-86 | pmid=12643357 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12643357  }} </ref><ref name="pmid22605909">{{cite journal| author=Goldenberg MM| title=Multiple sclerosis review. | journal=P T | year= 2012 | volume= 37 | issue= 3 | pages= 175-84 | pmid=22605909 | doi= | pmc=3351877 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22605909  }} </ref>
 {|
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
 ! rowspan="2" |Diseases
-! colspan="4" |History and Symptoms
+! colspan="4" |History and symptoms
-! colspan="4" |Physical Examination
+! colspan="4" |Physical examination
-! colspan="4" |Laboratory Findings
+! rowspan="2" |Laboratory findings
-! rowspan="2" |Other Findings
+! rowspan="2" |Other findings
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-!lightning pains
+!Lightning pains
-!impaired sensation
+!Impaired sensation
-!progressive sensory ataxia
+!Progressive sensory ataxia
-!unsteady gait
+!Unsteady gait
-!Physical Finding 1
+!Argyll-Robertson pupils
-!Physical Finding 2
+!Impaired vibratory and proprioception sense
-!Physical Finding 3
+!Broad base and sensory ataxic gait
-!Physical Finding 4
+!Positive Romberg's test
-!Lab Test 1
-!Lab Test 2
-!Lab Test 3
-!Lab Test 4
 |-
-|tabes dorsalis
+! style="background: #DCDCDC; padding: 5px; text-align: center;" |Tabes dorsalis
-| ++
+| style="background: #F5F5F5; padding: 5px;" | ++
-| ++
+| style="background: #F5F5F5; padding: 5px;" | ++
-| ++
+| style="background: #F5F5F5; padding: 5px;" | ++
-| ++
+| style="background: #F5F5F5; padding: 5px;" | ++
-|
+| style="background: #F5F5F5; padding: 5px;" |<nowiki>++</nowiki>
-|
+| style="background: #F5F5F5; padding: 5px;" |<nowiki>++</nowiki>
-|
+| style="background: #F5F5F5; padding: 5px;" |<nowiki>++</nowiki>
-|
+| style="background: #F5F5F5; padding: 5px;" |<nowiki>++</nowiki>
-|
+| style="background: #F5F5F5; padding: 5px;" |
-|
+* Positive [[VDRL]]
-|
+* [[RPR|Rapid plasma reagent]]
-|
+* [[FTA-ABS|FTA-ABS tests]]
-|
+| style="background: #F5F5F5; padding: 5px;" |<nowiki>-</nowiki>
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |B12 deficiency
+! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vitamin B12 deficiency|B12 deficiency]]
-| style="background: #F5F5F5; padding: 5px;" |+/-
+| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |+
+| style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
-| style="background: #F5F5F5; padding: 5px;" |+/-
+| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" | ++
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Megaloblastic anemia]],
+* Low plasma [[methylmalonic acid]] level
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Gastrointestinal]] symptoms
+* Glossitis
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |extrinsic spinal cord compression
+! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Spinal cord compression]]
 | style="background: #F5F5F5; padding: 5px;" | +/-
 | style="background: #F5F5F5; padding: 5px;" | +/-
 | style="background: #F5F5F5; padding: 5px;" | +/-
 | style="background: #F5F5F5; padding: 5px;" | +/-
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | +/-
+| style="background: #F5F5F5; padding: 5px;" | +/-
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
+* May be [[acute]], [[subacute]] or [[chronic]]
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Vitamin E deficiency
+! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vitamin E deficiency]]
-| style="background: #F5F5F5; padding: 5px;" |+/-
+| style="background: #F5F5F5; padding: 5px;" | +/-
+| style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |+
+| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |+/-
+| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Hemolytic anemia]]
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Muscle weakness|Muscle]]
+* [[Muscle weakness|Weakness]]
+* [[Retinopathy]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |multiple sclerosis
+! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple sclerosis]]
+| style="background: #F5F5F5; padding: 5px;" | +/-
+| style="background: #F5F5F5; padding: 5px;" | +/-
 | style="background: #F5F5F5; padding: 5px;" | +/-
 | style="background: #F5F5F5; padding: 5px;" | +/-
+| style="background: #F5F5F5; padding: 5px;" |Very rare
 | style="background: #F5F5F5; padding: 5px;" | +/-
+| style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | +/-
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Oligoclonal band|Oligoclonal bands of IgG]] on [[electrophoresis]] of [[cerebrospinal fluid]]
 | style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
+* [[Vision problems]]
-| style="background: #F5F5F5; padding: 5px;" |
+* [[Balance disorder|Balance problems]]
-| style="background: #F5F5F5; padding: 5px;" |
+* [[Dizziness]]
-| style="background: #F5F5F5; padding: 5px;" |
+* Areas of [[demyelination]] in [[CNS]] [[MRI]]
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-|}
-===Use if the above table can not be made===
-{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align="center"
-| valign="top" |
-|
-|+
-! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
-! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Similar Features}}
-! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 1
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 2
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 3
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 4
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 5
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
 |}
 ==References==
 {{Reflist|2}}

Tabes Dorsalis differential diagnosis: Difference between revisions

Latest revision as of 17:02, 13 March 2019

Overview

Differentiating tabes dorsalis from other Diseases

References

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