Tabes dorsalis
| Tabes dorsalis | |
|---|---|
| Other names | Syphilitic myelopathy |
 | |
| Axial section of the spinal cord showing syphilitic destruction (whitened area, upper center) of the posterior columns which carry sensory information from the body to the brain | |
| Specialty | Neurology |
Tabes dorsalis is a late consequence of
Signs and symptoms
Signs and symptoms may not appear for decades after the initial infection and include
"Tabes dorsalgia" is a related lancinating back pain.[citation needed]
"Tabetic gait" is a characteristic ataxic gait of untreated syphilis where the person's feet slap the ground as they strike the floor due to loss of proprioception. In daylight the person can avoid some unsteadiness by watching their own feet.[citation needed]
Cause
Tabes dorsalis is caused by
Diagnosis
Routine screening for syphilis. Treponomal antibody usually positive both in blood and in csf also. In CSF lymphocytosis and elevated protein found. Serological tests are usually positive.[citation needed]
Treatment
Prognosis
Left untreated, tabes dorsalis can lead to
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.[citation needed]
History
Although there were earlier clinical accounts of this disease, and descriptions and illustrations of the posterior columns of the spinal cord, it was the Berlin neurologist Romberg whose account became the classical textbook description, first published in German[4] and later translated into English.[5]
Society and culture
Notable patients
- E.T.A. Hoffmann appears to have had and died in 1882 [1]from tabes dorsalis.
- Mary Todd Lincoln [Dec 12, 1818 - Jul 16, 1882], wife of U.S. President Abraham Lincoln and America's First Lady in the Washington, DC from 1861 to 1865 most probably suffered from tabes dorsalis as early as 1869, at age 51. [2] She died of a stroke at age 63 in Springfield, IL. [3]
- The French novelist Alphonse Daudet kept a journal of the pain he experienced from this condition which was posthumously published as La Doulou (1930) and translated into English as In the Land of Pain (2002) by Julian Barnes.
- Poet Charles Baudelaire contracted syphilis in 1839 and resorted to opium to help alleviate the pain of tabes dorsalis ascending his spine.
- Painter Édouard Manet died of syphilis complications, including tabes dorsalis, in 1883, aged 51.
- Boxer Charley Mitchell
- Meyer Nudelman, the father of author and doctor Sherwin Nuland, who described his father's condition extensively in his book Lost in America; A Journey with my Father (2003).
See also
References
- ^ "Pel's Crisis". Retrieved December 14, 2009.[permanent dead link]
- ISBN 978-0-7817-5319-7
- ^ "NINDS Tabes Dorsalis Information Page". Archived from the original on April 14, 2014. Retrieved April 13, 2014.
- ^ Romberg, Moritz (1840). Lehrbuch der Nervenkrankheiten des Menschen. Berlin: Duncker.
- ^ Romberg, Moritz (1853). Tabes dorsalis. Chapter 49 in: A manual of the nervous diseases of man Vol 2 (Translated and edited by EH Sieveking ed.). London: New Sydenham Society. p. 395.
- hdl:1842/418.