tabes dorsalis

Question 1

what is tabes dorsalis?

Answer 1

the type of neurosyphilis 
usually develope 15 to 20 years
slow degeneration (demyelination ) of the sensory neurons in the dorsal column of spinal cord

Question 2

what are the major symptoms?

Answer 2

lightning pain (90 % cases)-sharp ,stabbing and brief like a flash of lightning (more frequent in legs than elsewhere but roam over the body from face to feet sometimes playing persistently on one spot like the repeated twanging of a fiddle string) they may come in bouts lasting several hours or days

pins and needles feeling 
coldness 
numbers 
tinging 
& other paresthesia are also present and are associated invariably with impairment of tactical pain and thermal sensation 

Ataxia (most prominent feature)
Pt. totter & staggers while standing & walking

the bladder is insensitive & hypotonic resulting in unpredictable overflow incontinence
urinary incontinence

constipation and magacolon as well as impotence are other expressions of dysfunction of the sacral roots and ganglia

the cheif sign are absent tendon reflex at knee and ankle
impaired vibratory & position sense in feet and legs
romberg sign positive
ataxia is due to purely to the sensory defect,muscular power, by contrast is fully retained in most cases

the pupil are abnormal in over 90 % of cases
usually argyll-roberston in type & the majority of the pt. shows ptosis or some degree of ophthalmoplegia .
optic atrophy is frequent

Question 3

balance depend on which system

Answer 3

visual system
proprioceptive system
vestibule system

Question 4

more common affected?

Answer 4

hip ,knee ,ankle most common affceted

lumbar spine can also affected

Question 5

prevention? in mgt?

Answer 5

ulcer
charcot joint
secondary changes
osteoarthritis

Question 6

type?

Answer 6

it is sensory neuropathy

Question 7

why? it is sensory neuropathy?!

Answer 7

becoz spinal cord are involvement

dorsal

Question 8

what are most involvement?

Answer 8

lower extremities are more involved

Question 9

why it is not called poly neuropathy?

Answer 9

because peripheral nerve are not involved they are all fine.

Question 10

when syphilis developed?

Answer 10

after 15-20 years

Question 11

probelm list participation activity limitation impairment

Answer 11

Sensory issue: proprioceptors, pressure, join sensations paresthesia pain lighting or pin needles - sensory re-education (closing the eye, maintaining the position)

UL

Question 12

causes?

Answer 12

caused by demyelination secondary to an untreated syphilis infection

Question 13

complications

Answer 13

syphilitic myelopathy is a complication of syphilis infection that involves muscle weakness and abnormal sensation

Question 14

age population

Answer 14

male> female

Question 15

onset

Answer 15

during midlife

Question 16

c/f

Answer 16

weakness 
diminished reflex 
paraesthesia (shooting & burning pains,pricking sensation)
hypothesisas(abnormally and burning pain,pricking sensation)
progressive degeneration of joints
loss of coordination 
personality changes 
urinary incontienence
dementia 
visual impairment 
positive romberg tets
impaired response to light
(agryll roberston pupil)
muscles are hypotonic due to destruction of 
the sensory limb of the spinal reflex
DTR are diminished or absent 
tabes dorsalgia related to back pain
tabetic gait is characteristic high stepping gait-tabetic atexia
deafness

Question 17

Prognosis

Answer 17

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