"Tabes dorsalis"

., psychosis)- Tabes dorsalis • Sensory ataxia (ataxia, impaired pallesthesia, impaired proprioception, areflexia) •Paroxysmal pain in the limbs, back and face •Incontinence • Argyll Robertson pupils are often a feature • Otic abnormalities (see OTOSYPHILIS) •Ocular abnormalities (see OCULAR syphilis)OCULAR syphilis Symptoms and signsDiagnoses (e.g., after a slit lamp examination) • Blurred vision • Redness

. * Substernal pain. * Aortic regurgitation. * Aortic aneurysm. * Heart failure. * Angina. Neurosyphilis * Tabes dorsalis (inflammation of spinal dorsal column/nerve roots) — may present with ‘lightening pains’, paraesthesia, Charcot’s joints, pupillary change, absent reflexes, joint position and vibration sense. * General paresis (cortical neuronal loss) — may present with forgetfulness and personality change

including aortic regurgitation. * Nervous system — looking for signs of tabes dorsalis or general paresis. * Eye examination — looking for signs of ocular disease. Refer for investigations * Refer to a genito-urinary medicine (GUM) specialist for laboratory investigations (such as dark-field microscopy and serology) and a full sexual health screen (including HIV testing). * For more information

current clinical features. * Tertiary syphilis — occurs in approximately one-third of untreated people 20–40 years after initial infection. May present with cardiac disease (for example aortic aneurysm), cutaneous disease (for example gummatous lesions), and/or neurological disease (for example tabes dorsalis and general paresis). [Janier, 2021; Peeling, 2023; BASHH, 2024] The content on the NICE

and cognitive function; hemiparesis and seizures may also occur. * Tabes dorsalis — progressive degeneration and inflammation of the spinal dorsal column/dorsal spinal nerve roots leading to ataxia, lancinating pain, paraesthesiae, Charcot’s spine and joints, and pupillary irregularities (Argyll-Robertson pupil). * Cardiovascular syphilis — chronic syphilis infection can lead to aortic aneurysm, aortic

dementia, and seizuresand hemiparesis may occur (late stage).·Tabes dorsalis occurs 15–25 years after infection(longest of neurological complications). It is charac-terised by sensory ataxia and lightning pains; pupillaryabnormalities are common (Argyll Robertson pupil) anddorsal column loss (absent reflexes, joint position andvibration sense) can be present.Clinical diagnosisHistory·A full and accurate , insomniaParenchymous•Generalparesis10–20 yearsCortical neuronal loss; gradual decline in memory and cognitive functions, emotionallability, personality change, psychosis and dementia. Seizures and hemiparesis are latecomplications•Tabes dorsalis 15–25 yearsInflammation of spinal dorsal column/nerve roots; lightning pains, areflexia, paraesthesia,sensory ataxia, Charcot’s joints, mal perforans, optic atrophy

hydrocephalus * Corticobasal degeneration * Progressive supranuclear palsy * Multiple system atrophy (MSA; striatonigral degeneration, Shy-Drager syndrome) * Spinal cord trauma * Guillain-Barre syndrome (GBS), polyradiculopathy * Spinal spondylosis * Spinal cord tumour * Neuromyelitis optica (NMO) * Subacute combined degeneration of the cord * Syphilis, tabes dorsalis * Tuberculosis (Pott's disease) * HIV

Novel and characteristic radiological features of neurosyphilis: a case series. Treponema pallidum can invade the central nervous system (CNS) early in its infection, causing neurosyphilis. Neurosyphilis typically presents with meningovasculitis in the acute or subacute phase, while tabes dorsalis and dementia paralytica are classical conditions in the later stages. However, syphilis is often

Neurosyphilis presenting with Guillain-Barre syndrome: a case report. Syphilis is associated with a wide variety of systemic presentations, earning it the moniker "The great mimicker". Neurosyphilis is classically associated with meningovasculitis in the acute-subacute stage and tabes dorsalis and dementia paralytica in later stages. However, one of the less well described presentations include

– granulomatous lesions of the skin, bone and organs. * Neurosyphilis presents in a variety of ways. It is most commonly asymptomatic, but may present as general paresis or tabes dorsalis in late stages. * General paresis – personality change, dementia, psychosis. * Tabes dorsalis – affects posterior column of the spinal cord, resulting in ataxia and lancinating pain.6 What are the diagnostic tests

translation of that German guideline. (a) Neurosyphilis can manifest as early neurosyphilis (meningitis, meningovascular neurosyphilis or syphilitic gummas) or late neurosyphilis (tabes dorsalis, general paresis). (b) The following diagnostic criteria help to establish the presence of probable neurosyphilis (always point iv, accompanied by any two of points i to iii): (i) subacute or chronic neuro

in mental status, meningitis, stroke, cranial nerve dysfunction and auditory or ophthalmic and ocular abnormalities. Late neurosyphilis occurs 10 –30 years or more after infection and is characterized by tabes dorsalis and general paresis.The most common manifestation of congenital syphilis is second or third trimester fetal loss or premature labour. Thus, serologic testing for syphilis should

nervous system (neurosyphilis) can occur at any stage of disease and can result in blindness, paresis, tabes dorsalis, and dementia. Syphilis infection also increases the risk for acquiring or transmitting HIV infection.The USPSTF addresses screening for syphilis in pregnant women in a separate recommendation statement.3DetectionThere are numerous screening tests for syphilis. Most common cranial nerve dysfunction, meningitis stroke, acute altered mental status, and auditory or ophthalmic abnormalities; late neurologic manifestations include tabes dorsalis and general paresis and can occur 10 to 30 years after initial infection.9 Syphilis can be sexually transmitted during the early stages of infection (primary, secondary, and early-latent syphilis); reported transmission rates range

, often divided into early and late latent syphilis at a cutoff of 1 or 2 years depending on which guideline you follow.Tertiary syphilis (aka late symptomatic disease) occurs in 10-40% of patients with untreated syphilis, and is characterized by chronic end-organ complications, usually occurring 10-20 years after the onset of infection. Neurosyphilis of the spine (aka tabes dorsalis) can cause ataxia

paresis.Progressive dementing illness 10–25 years after infec-tion secondary to cortical neuronal loss.Initial forgetfulness and personality change whichdevelop into severe dementia. Seizures and hemipar-esis may occur (late)Tabes dorsalis.15–25 years after infection (longest of neurologicalcomplications).Characterised by sensory ataxia and lighting pains.Pupillary abnormalities common (Argyll-Robertson).Dorsal ; Tabes dorsalis: pupil abnormalities,impaired reflexes, impaired vibration andjoint position sense, sensory ataxia and opticatrophy)Laboratory diagnosisDemonstration ofT. pallidumfrom lesions orinfected lymph nodes.Dark ground microscopy:35.Should be performed by experienced observers.Is less reliable in examining rectal and non-penilegenital lesions and not suitable for examining

is by no means exhaustive. There are many other rarer causes of abdominal pain, including familial Mediterranean fever, tabes dorsalis and worm infestation. There is also the possibility of Münchhausen's syndrome. InvestigationsThe choice of investigations will depend upon the findings above.FBC, ESR and CRP may give an indication of infection or an inflammatory process although are unable to determine acute

, pernicious anaemia, poliomyelitis, radical pelvic surgery, spinal cord trauma, tabes dorsalis).Brain (eg, cardiovascular disease (CVD), multiple sclerosis (MS), neoplasm, normal pressure hydrocephalus, Parkinson's disease).Spinal cord (eg, invertebral disc disease, meningomyelocele, MS, spina bifida occulta, spinal cord haematoma or abscess, spinal cord trauma, spinal stenosis, spinovascular disease