Tabes dorsalis is a progressive degeneration of nerve cells and fibers in the spinal cord that carry sensory information to the brain, caused by untreated syphilis. It is characterized by sensory deficits, loss of coordination, and diminished reflexes. The disease progresses through preataxic, ataxic, and paralysis stages. Clinical features include loss of sensation, Argyll Robertson pupils, dementia, hypotonicity, loss of coordination, and trophic ulcers. Treatment involves antibiotics, steroids, pain medications, exercises, and splinting to manage symptoms.

1. TABES DORSALIS
KEERTHI PRIYA MPT NEURO,
ASSISTANT PROFESSOR

2. INTRODUCTION
Progressive degeneration of nerve cells & nerve fibres that carry sensory
information to the brain information to the brain, characterised by
 sensory deficits
Loss of neuromuscular coordination
Diminished reflexes

3. INTRODUCTION
Also called as PROGRESSIVE LOCOMOTOR ATAXIA.
Caused by Treponema Pallidum
Commonly because of untreated syphilis
Males are more affected
Insidious onset & progresses gradually
Latent period is 8-12 years.

4. STAGES
PREATAXIC
ATAXIC
PARALYSIS

5. CLINICAL FEATURES
SENSORY CHANGES:
Loss of pain sensation ( L.L followed by UL)
Lightining pain
Paraesthesia

6. CLINICAL FEATURES
SENSORY CHANGES:
Loss of vibration & proprioception
Unable to sense the sitting surface
Unable to sense the walking surface

7. CLINICAL FEATURES
SPECIAL SENSES:
Cortical blindness
Deafness
Argyll Robertson pupil
Atrophic depigmentation in iris

8. CLINICAL FEATURES
APPEARANCE:
 Wrinkled fore head
Ptosis
HMF:
Dementia
Personality changes

9. CLINICAL FEATURES
NEUROMUSCULAR :
 Hypotonicity
Charcot joints
Diminished reflexes ( ankle & knee)
Postural instability
Loss of coordination
Wide base high stepping gait

10. CLINICAL FEATURES
BLADDER & BOWEL :
 Loss of bladder sensation
Large & atonic bladder
Constipation
Faecal incontinence
Impotence

11. CLINICAL FEATURES
TROPHIC CHANGES:
Painless perforating ulcers at great toe & other pressure prone areas
Tabetic crises

12. MANAGEMENT
Pencillin
Prednisone 30mg for 10 days
Opiates
Valproate
Carbamazepine

13. MANAGEMENT
Electrical Stimulations
Strength Training
Balance Training
Coordination Exercises
Splinting

14. MANAGEMENT
Laser for ulcers
Ultrasound for joints
 Gait Training Over Parallel Bars
Sensory Integration Therapy
Walk on different terrains

15. REFERENCES
CLINICAL NEUROLOGY BY BANNISTER
https://www.britannica.com/science/tabes-dorsalis
https://www.ninds.nih.gov/Disorders/All-Disorders/Tabes-Dorsalis-Information-
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16. ANY QUEREY ?