Which of the following is not true about tabes Dorsalis
Ans. is b' i.e., Deep tendon reflexes are brisk Tabes dorsalis Usually develops 15 - 20 years after syphilis infection Major symptoms are- lightning pain, ataxia, urinary incontinence Lightning pain Lightning or lancinating pain are sharp stabbing pain and brief like a flash of lightning. o More common in legs. Are associated invariably with impairment of tactile pain and thermal sensation. Urinary incontinence Bladder is insensitive and hypotonic resulting in unpredictable overflow incontinence Sometimes constipation, megacolon as well as impotence can occur Ataxia Purely sensory ataxia Charcoat joints and trophic ulcers can occur Pathology: There is involvement of : Involvement of posterior root of lumbosacral region o Posterior column involved Dorsal root ganglia Now, it is believed that inflammation is present all along the posterior root where as the dorsal ganglion cell loss and posterior column degeneration are secondary Clinicopathological correlation Clinical feature Tract involved Hyptonia, areflexia ataxia - Destruction of proprioceptive fibres in sensory root ganglia Bladder involvement - Posterior root involvement of lumbosacral region Lightning pains - Incomplete posterior root lesions at different levels Analgesia and joint insensitivity - Paial loss of A and C fibres in the root.
Seen in Neurosyphillis
Deep tendon reflexes are brisk
Loss of vibration sense
Acute abdominal pain and visceral symptoms