Tabes Dorsalis differential diagnosis: Difference between revisions

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{{Tabes dorsalis}}
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==Differentiating tabes dorsalis from other Diseases==
==Differentiating tabes dorsalis from other Diseases==
*Tabes dorsalis must be differentiated from other diseases that cause lightning pains, impaired [[sensation]] and [[proprioception]], and progressive [[sensory ataxia]] and [[unsteady gait]]([[locomotor ataxia]]) and [[Sexual function]] problems, such as [[vitamin B12 deficiency]], extrinsic [[spinal cord compression]], [[vitamin E deficiency]] and [[multiple sclerosis]].<ref name="pmid18712629">{{cite journal| author=Clarke MW, Burnett JR, Croft KD| title=Vitamin E in human health and disease. | journal=Crit Rev Clin Lab Sci | year= 2008 | volume= 45 | issue= 5 | pages= 417-50 | pmid=18712629 | doi=10.1080/10408360802118625 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18712629  }} </ref><ref name="pmid22547256">{{cite journal| author=Ribas ES, Schiff D| title=Spinal cord compression. | journal=Curr Treat Options Neurol | year= 2012 | volume= 14 | issue= 4 | pages= 391-401 | pmid=22547256 | doi=10.1007/s11940-012-0176-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22547256  }} </ref><ref name="pmid12643357">{{cite journal| author=Oh R, Brown DL| title=Vitamin B12 deficiency. | journal=Am Fam Physician | year= 2003 | volume= 67 | issue= 5 | pages= 979-86 | pmid=12643357 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12643357  }} </ref><ref name="pmid22605909">{{cite journal| author=Goldenberg MM| title=Multiple sclerosis review. | journal=P T | year= 2012 | volume= 37 | issue= 3 | pages= 175-84 | pmid=22605909 | doi= | pmc=3351877 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22605909  }} </ref>
*Tabes dorsalis must be differentiated from other diseases that cause lightning pains, impaired [[sensation]] and [[proprioception]], and progressive [[sensory ataxia]] and [[unsteady gait]] ([[locomotor ataxia]]) and [[sexual function]] problems, such as [[vitamin B12 deficiency]], extrinsic [[spinal cord compression]], [[vitamin E deficiency]] and [[multiple sclerosis]].<ref name="pmid18712629">{{cite journal| author=Clarke MW, Burnett JR, Croft KD| title=Vitamin E in human health and disease. | journal=Crit Rev Clin Lab Sci | year= 2008 | volume= 45 | issue= 5 | pages= 417-50 | pmid=18712629 | doi=10.1080/10408360802118625 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18712629  }} </ref><ref name="pmid22547256">{{cite journal| author=Ribas ES, Schiff D| title=Spinal cord compression. | journal=Curr Treat Options Neurol | year= 2012 | volume= 14 | issue= 4 | pages= 391-401 | pmid=22547256 | doi=10.1007/s11940-012-0176-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22547256  }} </ref><ref name="pmid12643357">{{cite journal| author=Oh R, Brown DL| title=Vitamin B12 deficiency. | journal=Am Fam Physician | year= 2003 | volume= 67 | issue= 5 | pages= 979-86 | pmid=12643357 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12643357  }} </ref><ref name="pmid22605909">{{cite journal| author=Goldenberg MM| title=Multiple sclerosis review. | journal=P T | year= 2012 | volume= 37 | issue= 3 | pages= 175-84 | pmid=22605909 | doi= | pmc=3351877 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22605909  }} </ref>
{|
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="2" |Diseases
! rowspan="2" |Diseases
! colspan="4" |History and Symptoms
! colspan="4" |History and symptoms
! colspan="4" |Physical Examination
! colspan="4" |Physical examination
! rowspan="2" |Other Findings
! rowspan="2" |Laboratory findings
! rowspan="2" |Other findings
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Lightning pains
!Lightning pains
!Impaired sensation
!Impaired sensation
!progressive sensory ataxia  
!Progressive sensory ataxia  
!unsteady gait
!Unsteady gait
!Argyll-Robertson pupils
!Argyll-Robertson pupils
!impaired vibratory and proprioception sense
!Impaired vibratory and proprioception sense
!broad base and sensory ataxic gait
!Broad base and sensory ataxic gait
!positive Romberg's test
!Positive Romberg's test
|-
|-
|tabes dorsalis
! style="background: #DCDCDC; padding: 5px; text-align: center;" |Tabes dorsalis
| ++
| style="background: #F5F5F5; padding: 5px;" | ++
| ++
| style="background: #F5F5F5; padding: 5px;" | ++
| ++
| style="background: #F5F5F5; padding: 5px;" | ++
| ++
| style="background: #F5F5F5; padding: 5px;" | ++
|<nowiki>++</nowiki>
| style="background: #F5F5F5; padding: 5px;" |<nowiki>++</nowiki>
|<nowiki>++</nowiki>
| style="background: #F5F5F5; padding: 5px;" |<nowiki>++</nowiki>
|<nowiki>++</nowiki>
| style="background: #F5F5F5; padding: 5px;" |<nowiki>++</nowiki>
|<nowiki>++</nowiki>
| style="background: #F5F5F5; padding: 5px;" |<nowiki>++</nowiki>
|
| style="background: #F5F5F5; padding: 5px;" |
* Positive [[VDRL]]
* [[RPR|Rapid plasma reagent]]
* [[FTA-ABS|FTA-ABS tests]]
| style="background: #F5F5F5; padding: 5px;" |<nowiki>-</nowiki>
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |B12 deficiency
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vitamin B12 deficiency|B12 deficiency]]
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
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| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" |megaloblastic anemia
| style="background: #F5F5F5; padding: 5px;" |
* [[Megaloblastic anemia]],
* Low plasma [[methylmalonic acid]] level
| style="background: #F5F5F5; padding: 5px;" |
* [[Gastrointestinal]] symptoms
* Glossitis
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |extrinsic spinal cord compression
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Spinal cord compression]]
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
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| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
may be
* May be [[acute]], [[subacute]] or [[chronic]]
 
acute, subacute or chronic
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Vitamin E deficiency
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vitamin E deficiency]]
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
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| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |Muscle weakness
| style="background: #F5F5F5; padding: 5px;" |
* [[Hemolytic anemia]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Muscle weakness|Muscle]]
* [[Muscle weakness|Weakness]]
* [[Retinopathy]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |multiple sclerosis
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple sclerosis]]
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" |very rare
| style="background: #F5F5F5; padding: 5px;" |Very rare
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" |vision problems'
| style="background: #F5F5F5; padding: 5px;" |
 
* [[Oligoclonal band|Oligoclonal bands of IgG]] on [[electrophoresis]] of [[cerebrospinal fluid]]
balance problems or dizziness.
| style="background: #F5F5F5; padding: 5px;" |
* [[Vision problems]]
* [[Balance disorder|Balance problems]]
* [[Dizziness]]
* Areas of [[demyelination]] in [[CNS]] [[MRI]]


|}
|}

Latest revision as of 17:02, 13 March 2019

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.
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