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Back tabes


Back the tabes or tabes belong to the latest (fourth) period of syphilis. Now back the tabes, or tabes dorsalis, meet extremely seldom. Usually it develops in 15–25 years after infection.

Symptoms Back tabes:

Sensitive frustration are characteristic: segmented paresthesias, a radicular hypesthesia and a hyperesthesia, pains which can be the first display of a disease. They have the shooting, piercing character, are localized in the lower extremities, appear suddenly, "immediately", proceed paroksizmalno. Early enough decrease, and then tendon jerks on the lower extremities are lost: at first disappear knee, then calcaneal (akhillova). Cutaneous reflexes remain live. Decrease or full loss of deep types of sensitivity belongs to typical manifestations back tabes. Before everything the feeling of vibration suffers, then muscular and joint sensitivity decreases. Disorders of sensitivity are expressed more in the lower extremities. Decrease in muscular and joint feeling conducts to the sensitive ataxy developing parallel to increase of sensitive disturbances. The first sign of the developing ataxy is difficulty when walking in the dark, in the absence of sight control. Gait becomes uncertain, shaky. The hypomyotonia more expressed in legs belongs to characteristic symptoms back tabes. Disorders of functions of pelvic bodies are typical.

Pupillary frustration belong to frequent, early and characteristic symptoms: a miosis, an anisocoria, changes of a form of pupils, slackness of a pupillary test on light, Argayl Robertson's syndrome. Also defeat II, III, VI and VIII pairs of cranial nerves is observed. Primary tabic atrophy of optic nerves within several months leads to a blindness.

Trophic disturbances at back to tabes are shown by the expressed general weight loss, thinning of skin pro-butting ulcers of feet, painless arthropathies, a hair loss, teeth.

Tabic crises belong to features of clinical manifestations back tabes: the attacks of pains in internals which are followed by disturbance of their functions.

In recent years the classical clinical picture back tabes meets extremely seldom. The disease proceeds in the erased forms, malosimptomno. The current is long, slowly progressing. Earlier in a course of a disease allocated neuralgic, atactic and paralytic stages. However the disease seldom passes all three stages, and accepts stationary character, for example, in an initial neuralgic stage.

In early stages pupillary disturbances, the shooting pains, an urination delay, the segmented surrounding paresthesias, a cold hyperesthesia in a back, and also tabic crises have diagnostic value. In later terms – atactic frustration.

Внешний вид больного при спинной сухотке

Outward of the patient at back to tabes

Reasons Back tabes:

Macroscopically the atrophy of back cords of a spinal cord and back roots is found. The soft cover of a spinal cord is thickened, a mutna. Microscopically degenerative changes in Gaulle and Burdakh's conduction paths, in back roots, in nervous elements of the back horns of a spinal cord which are carrying out impulses from back horns to front come to light; inflammatory changes of a soft cover of a spinal cord are localized generally on its back surface. The degenerative phenomena are found also in some cranial nerves, prevertebral vegetative gangliya, spinal nodes.

Treatment Back tabes:

Concerning recovery bad. In cases of a high-quality current, unsharply expressed ataxy, stabilization of process in a neuralgic stage patients can long keep working capacity. Increase of an ataxy, tabic cachexia leads to an invalidism. Gross violations of function of pelvic bodies are the reason of accession of consecutive infection (cystitis, pyelonephritises). Death usually is caused by intercurrent diseases.

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