Tabes Dorsalis differential diagnosis

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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

Tabes dorsalis must be differentiated from other diseases that cause lightning pains, impaired sensation, ataxia and unsteady gait, such as vitamin B12 deficiency, extrinsic spinal cord compression, vitamin E deficiency and multiple sclerosis.

Differentiating tabes dorsalis from other Diseases

Diseases History and symptoms Physical examination Laboratory findings Other findings
Lightning pains Impaired sensation Progressive sensory ataxia Unsteady gait Argyll-Robertson pupils Impaired vibratory and proprioception sense Broad base and sensory ataxic gait Positive Romberg's test
Tabes dorsalis ++ ++ ++ ++ ++ ++ ++ ++ -
B12 deficiency +/- + + +/- +/- ++ + +/-
Spinal cord compression +/- +/- +/- +/- - +/- +/- - -
Vitamin E deficiency +/- + + +/- - +/- - -
Multiple sclerosis +/- +/- +/- +/- Very rare +/- - +/-

References

  1. Clarke MW, Burnett JR, Croft KD (2008). "Vitamin E in human health and disease". Crit Rev Clin Lab Sci. 45 (5): 417–50. doi:10.1080/10408360802118625. PMID 18712629.
  2. Ribas ES, Schiff D (2012). "Spinal cord compression". Curr Treat Options Neurol. 14 (4): 391–401. doi:10.1007/s11940-012-0176-7. PMID 22547256.
  3. Oh R, Brown DL (2003). "Vitamin B12 deficiency". Am Fam Physician. 67 (5): 979–86. PMID 12643357.
  4. Goldenberg MM (2012). "Multiple sclerosis review". P T. 37 (3): 175–84. PMC 3351877. PMID 22605909.