When the outer layers of nerve cells and fibers begin to degenerate, the condition is known as tabes dorsalis. It is typically the result of an untreated syphilis infection, and is more frequent in males than in females. Symptoms usually begin about 25 to 30 years after the original syphilis infection, and may include weakness, foot ulcers, and loss of coordination.
Tabes dorsalis is a slow degeneration of the covering of nerve cells and nerve fibers (known as myelin) that carry sensory information to the brain. The degenerating nerves are in the dorsal column of the spinal cord (the portion closest to the back of the body) and carry information that help maintain a person's sense of position. Tabes dorsalis results when a syphilis infection goes untreated.
Tabes dorsalis is more frequent in males than in females. The incidence is rising, in part due to co-associated HIV infection. It is usually diagnosed during mid-life.
Symptoms of tabes dorsalis usually begin about 25 to 30 years after the original syphilis infection. Common symptoms can include:
- Episodes of intense pain and disturbed sensation
- Diminished reflexes
- Unsteady gait
- Foot slap
- Progressive degeneration of the joints (Charcot's joints)
- Foot ulcers
- Loss of coordination
- Personality changes
- Visual impairment
- Small, unusually shaped pupil with impaired response to light (Argyll Robertson pupil).
The treatment of choice for tabes dorsalis is antibiotics. The drug that is normally recommended is penicillin, given intravenously (IV). Pain associated with tabes dorsalis can be treated with medications such as opiates, valproate, or carbamazepine. People with this condition may also require physical or rehabilitative therapy to deal with muscle wasting and weakness.
Preventive treatment for those who come into sexual contact with an individual with tabes dorsalis is important.