Tabes Dorsalis natural history, complications, and prognosis: Difference between revisions
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{{Tabes dorsalis}} | {{Tabes dorsalis}} | ||
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== | ==Overview== | ||
The [[Symptom|symptoms]] of tabes dorsalis usually develop secondary to long-term untreated [[syphilis]], and start with symptoms such as lightning pains, impaired [[sensation]] and [[proprioception]], and [[Hypesthesia|hypesthesias]]. Common complications of tabes dorsalis include [[Dementia]], [[stroke]], [[eye disease]], [[Paralysis]], and [[Charcot joint|Charcot arthropathy]] ([[Charcot joint]]). | |||
==Natural History, Complications, and Prognosis== | |||
==Prognosis== | ===Natural History=== | ||
The [[Symptom|symptoms]] of tabes dorsalis usually develop secondary to long-term untreated [[syphilis]], and start with symptoms such as: | |||
* Lightning pains<ref name="pmid19487174">{{cite journal| author=MAO S, LIU Z| title=Neurosyphilis manifesting as lightning pain. | journal=Eur J Dermatol | year= 2009 | volume= 19 | issue= 5 | pages= 504-6 | pmid=19487174 | doi=10.1684/ejd.2009.0712 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19487174 }} </ref> | |||
*Impaired [[sensation]] and [[proprioception]]<ref name="pmid15224672">{{cite journal| author=Vora SK, Lyons RW| title=The medical Kipling--syphilis, tabes dorsalis, and Romberg's test. | journal=Emerg Infect Dis | year= 2004 | volume= 10 | issue= 6 | pages= 1160-2 | pmid=15224672 | doi=10.3201/eid1006.031117 | pmc=3323152 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15224672 }} </ref> | |||
*[[Hypesthesia|Hypesthesias]]<ref name="pmid22330117">{{cite journal| author=Pandey S| title=Magnetic resonance imaging of the spinal cord in a man with tabes dorsalis. | journal=J Spinal Cord Med | year= 2011 | volume= 34 | issue= 6 | pages= 609-11 | pmid=22330117 | doi=10.1179/2045772311Y.0000000041 | pmc=3237288 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22330117 }} </ref>. | |||
The symptoms of tabes dorsalis typically occurs 10 to 30 years after primary infection by [[Treponema pallidum|treponema pallidum.]]<ref name="pmid14749871">{{cite journal| author=Schöfer H| title=[Syphilis. Clinical aspects of Treponema pallidum infection]. | journal=Hautarzt | year= 2004 | volume= 55 | issue= 1 | pages= 112-9 | pmid=14749871 | doi=10.1007/s00105-003-0608-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14749871 }} </ref> | |||
If left untreated, most patients with tabes dorsalis may progress to develop [[paralysis]], [[dementia]], and [[blindness]]. | |||
===Complications=== | |||
Common complications of tabes dorsalis include:<ref name="pmid23919113">{{cite journal| author=Kaynak G, Birsel O, Güven MF, Oğüt T| title=An overview of the Charcot foot pathophysiology. | journal=Diabet Foot Ankle | year= 2013 | volume= 4 | issue= | pages= | pmid=23919113 | doi=10.3402/dfa.v4i0.21117 | pmc=3733015 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23919113 }} </ref><ref name="pmid19148316">{{cite journal| author=Tso MK, Koo K, Tso GY| title=Neurosyphilis in a non-HIV patient: more than a psychiatric concern. | journal=Mcgill J Med | year= 2008 | volume= 11 | issue= 2 | pages= 160-3 | pmid=19148316 | doi= | pmc=2582679 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19148316 }} </ref> | |||
* [[Dementia]], [[stroke]], [[eye disease]] | |||
* [[Paralysis]] | |||
*[[Charcot joint|Charcot arthropathy]] ([[Charcot joint]]) of the foot may be seen | |||
*Broad base gate and [[Sensory ataxia|sensory ataxic gait]] is usually seen in patients with tabes dorsalis | |||
===Prognosis=== | |||
Prognosis varies by site of involvement and duration of disease:<ref name="pmid1951814">{{cite journal| author=Thomas SB, Quinn SC| title=The Tuskegee Syphilis Study, 1932 to 1972: implications for HIV education and AIDS risk education programs in the black community. | journal=Am J Public Health | year= 1991 | volume= 81 | issue= 11 | pages= 1498-505 | pmid=1951814 | doi= | pmc=1405662 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1951814 }} </ref><ref name="pmid13301322">{{cite journal| author=GJESTLAND T| title=The Oslo study of untreated syphilis; an epidemiologic investigation of the natural course of the syphilitic infection based upon a re-study of the Boeck-Bruusgaard material. | journal=Acta Derm Venereol Suppl (Stockh) | year= 1955 | volume= 35 | issue= Suppl 34 | pages= 3-368; Annex I-LVI | pmid=13301322 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13301322 }} </ref><ref name="pmid10194456">{{cite journal| author=Singh AE, Romanowski B| title=Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. | journal=Clin Microbiol Rev | year= 1999 | volume= 12 | issue= 2 | pages= 187-209 | pmid=10194456 | doi= | pmc=88914 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10194456 }} </ref> | |||
* Among patients with [[neurosyphilis]], 90% respond to treatment. | |||
* [[Gummatous]] lesions reverse with treatment. | |||
* Mortality rates are high with cardiovascular complications. | |||
* Mortality rate of patients with [[Tertiary syphilis|neurosyphilis]] is around 20% which is mainly due to related complications. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category: (name of the system)]] | |||
Latest revision as of 20:48, 28 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
The symptoms of tabes dorsalis usually develop secondary to long-term untreated syphilis, and start with symptoms such as lightning pains, impaired sensation and proprioception, and hypesthesias. Common complications of tabes dorsalis include Dementia, stroke, eye disease, Paralysis, and Charcot arthropathy (Charcot joint).
Natural History, Complications, and Prognosis
Natural History
The symptoms of tabes dorsalis usually develop secondary to long-term untreated syphilis, and start with symptoms such as:
- Lightning pains[1]
- Impaired sensation and proprioception[2]
- Hypesthesias[3].
The symptoms of tabes dorsalis typically occurs 10 to 30 years after primary infection by treponema pallidum.[4]
If left untreated, most patients with tabes dorsalis may progress to develop paralysis, dementia, and blindness.
Complications
Common complications of tabes dorsalis include:[5][6]
- Charcot arthropathy (Charcot joint) of the foot may be seen
- Broad base gate and sensory ataxic gait is usually seen in patients with tabes dorsalis
Prognosis
Prognosis varies by site of involvement and duration of disease:[7][8][9]
- Among patients with neurosyphilis, 90% respond to treatment.
- Gummatous lesions reverse with treatment.
- Mortality rates are high with cardiovascular complications.
- Mortality rate of patients with neurosyphilis is around 20% which is mainly due to related complications.
References
- ↑ MAO S, LIU Z (2009). "Neurosyphilis manifesting as lightning pain". Eur J Dermatol. 19 (5): 504–6. doi:10.1684/ejd.2009.0712. PMID 19487174.
- ↑ Vora SK, Lyons RW (2004). "The medical Kipling--syphilis, tabes dorsalis, and Romberg's test". Emerg Infect Dis. 10 (6): 1160–2. doi:10.3201/eid1006.031117. PMC 3323152. PMID 15224672.
- ↑ Pandey S (2011). "Magnetic resonance imaging of the spinal cord in a man with tabes dorsalis". J Spinal Cord Med. 34 (6): 609–11. doi:10.1179/2045772311Y.0000000041. PMC 3237288. PMID 22330117.
- ↑ Schöfer H (2004). "[Syphilis. Clinical aspects of Treponema pallidum infection]". Hautarzt. 55 (1): 112–9. doi:10.1007/s00105-003-0608-0. PMID 14749871.
- ↑ Kaynak G, Birsel O, Güven MF, Oğüt T (2013). "An overview of the Charcot foot pathophysiology". Diabet Foot Ankle. 4. doi:10.3402/dfa.v4i0.21117. PMC 3733015. PMID 23919113.
- ↑ Tso MK, Koo K, Tso GY (2008). "Neurosyphilis in a non-HIV patient: more than a psychiatric concern". Mcgill J Med. 11 (2): 160–3. PMC 2582679. PMID 19148316.
- ↑ Thomas SB, Quinn SC (1991). "The Tuskegee Syphilis Study, 1932 to 1972: implications for HIV education and AIDS risk education programs in the black community". Am J Public Health. 81 (11): 1498–505. PMC 1405662. PMID 1951814.
- ↑ GJESTLAND T (1955). "The Oslo study of untreated syphilis; an epidemiologic investigation of the natural course of the syphilitic infection based upon a re-study of the Boeck-Bruusgaard material". Acta Derm Venereol Suppl (Stockh). 35 (Suppl 34): 3–368, Annex I-LVI. PMID 13301322.
- ↑ Singh AE, Romanowski B (1999). "Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features". Clin Microbiol Rev. 12 (2): 187–209. PMC 88914. PMID 10194456.