What Causes Tabes Dorsalis and How is it Treated?

Tabes Dorsalis or Syphilitic Myelopathy is a pathological condition in which there is gradual degeneration of nerves normally in the posterior column of the spinal cord. These nerves are responsible for an individual having a sense of position which in medical terms is known as proprioception and a sense of touch.

Tabes Dorsalis or Syphilitic Myelopathy is a type of neurosyphilis. Neurosyphilis is a complication of syphilis infection. Syphilis as we know is caused by improper sexual activities. Tabes Dorsalis is a complication of this infection which damages the tissues of the spinal cord resulting in decreased function of the muscles with progressive weakness of the upper and lower extremities. This may ultimately cause paralysis. Since there is a problem with coordination thus there will be walking difficulties. An affected individual will also experience sensation differences and paresthesia. There may also be vision changes or psychiatric abnormalities. Since syphilis is the primary reason for Tabes Dorsalis, it has become very rare as people are now aware as to what precautions to take before sexual activity and even if a person gets syphilis infection it gets treated early successfully.

Some of the symptoms of Tabes Dorsalis are:

• Sensation abnormality
• Ambulation difficulties
• Discoordination
• Areflexia
• Muscle weakness
• Wide based gait
• Shooting Pain
• Degeneration of joints
• One of the symptoms of Tabes Dorsalis is, it can affect your eyes, cause pain in the eyes and also cause sensitivity to light.

When a physical examination is conducted there will be characteristic features of a myelopathy. Nerve damage will be suggested by the presence of areflexia. Apart from this, the physician may also order certain tests to include CT scans of the head, spine, brain and spinal cord. A serum RPR may be ordered if syphilis is suspected in order to confirm it. If positive, a CSF examination may also be done to confirm the diagnosis of Tabes Dorsalis.

The main aim of treatment Tabes Dorsalis is to treat the Syphilis infection first so as more damage to the nerve is not caused. If the Syphilis infection is treated in a timely manner then the disease stops progressing and there is significant reduction of symptoms but it does not reverse the damage already caused to the nerves due to the infection. The medication of choice for treatment of infection is aqueous penicillin G which is administered as an injectable. In case if the patient suffering from Tabes Dorsalis is allergic to penicillin then the patient will have to undergo desensitization in order to safely administer this medication. In case of some of the nerves that have already been damaged then supportive care will be required to aid in walking, eating and the like. For symptoms of muscle weakness in Tabes Dorsalis, physical and occupational therapy is quite useful. Pain control can be achieved by taking pain medications in the form of aspirin or Tylenol. In some cases of Tabes Dorsalis, mild form of narcotics may also be prescribed. In some cases of Tabes Dorsalis, antiepileptics are also given for control of pain and paresthesias. If this disease is left untreated it may cause paralysis, dementia, and blindness due to degeneration of the nerves because of Tabes Dorsalis.