Tabes dorsalis is a late consequence of neurosyphilis, characterized by the slow degeneration (specifically, demyelination) of the neural tracts primarily in the dorsal root ganglia of the spinal cord (nerve root). These patients have lancinating nerve root pain which is aggravated by coughing, and features of sensory ataxia with ocular involvement. Signs and symptoms
Signs and symptoms may not appear for decades after the initial infection and include weakness, diminished reflexes, paresthesias (shooting and burning pains, pricking sensations, and formication), hypoesthesias (abnormally diminished sense of touch), tabetic gait (locomotor ataxia), progressive degeneration of the joints, loss of coordination, episodes of intense pain and disturbed sensation (including glossodynia), personality changes, urinary incontinence, dementia, deafness, visual impairment, positive Rombergs test, and impaired response to light (Argyll Robertson pupil). The skeletal musculature is hypotonic due to destruction of the sensory limb of the spindle reflex. The deep tendon reflexes are also diminished or absent; for example, the "knee jerk" or patellar reflex may be lacking (Westphals sign). A complication of tabes dorsalis can be transient neuralgic paroxysmal pain affecting the eyes and the ophthalmic areas, previously called "Pels crises" after Dutch physician P.K. Pel. Now more commonly called "tabetic ocular crises", an attack is characterized by sudden, intense eye pain, tearing of the eyes and sensitivity to light. "Tabes dorsalgia" is a related lancinating back pain. "Tabetic gait" is a characteristic ataxic gait of untreated syphilis where the persons feet slap the ground as they strike the floor due to loss of proprioception.
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 and later translated into English.Sir Arthur Conan Doyle, author of the Sherlock Holmes stories, completed his doctorate on tabes dorsalis in 1885.

Notable patients
German storywriter E.T.A. Hoffmann appears to have had and died from tabes dorsalis. 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 fathers condition extensively in his book Lost in America; A Journey with my Father (2003). See also
General paresis of the insane
Category:Deaths from tabes dorsalis

References
tabes_dorsalis at NINDS
An Essay Upon the Vasomotor Changes in Tabes Dorsalis by Arthur Conan Doyle


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