Spinal cord( tabes dorsalis) is a kind of late form of neurosyphilis.
The disease involves degenerative changes in the column of the spinal cord. The process mostly covers the lumbosacral department.
As a rule, the disease manifests 15 - 20 years after the primary disease with syphilis. The causative agents of syphilis penetrate into the departments of the nervous system, affecting it.
Symptoms of the disease
When the disease comes to the fore, there are violations of sensitivity and reflexes.
The disease is accompanied by sharp shooting pains, which are caused by irritation of the posterior roots of the spinal cord. There are such painful sensations unexpectedly.
As a rule, they are localized in the lower limbs. When the patient is examined, the doctor discovers a decrease in reflexes in the area of the knees and heels. Skin reflexes are not lost.
Paresthesias( sensory disorders) are segmental. Patients complain of constriction in the abdomen, a feeling of numbness or burning sensation in the body.
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Additionally, spinal cord has such signs and symptoms:
- A decrease in the muscular function of expressed in hypotension inevitably entails such a complication as ataxia. The first manifestation of it is considered to be the impossibility of walking in a dark room.
- The patient moves uncertainly, swaying. It is interesting that tries to walk, a very sick person raises his legs very high and strikes the floor with force .
- For the patient it seems impossible to descend the ladder .Without a stick, he simply can not walk. It should be noted that, much earlier than the fall in the level of the musculo-articular sensitivity, the vibrational sensitivity falls.
- For disease, disorders in the pelvic area of are typical. The first target is the bladder. The patient complains of the impossibility of emptying it to the end. Sometimes the urine does not exit at all, and the bladder is emptied artificially with the help of a catheter. A frequent phenomenon is considered to be the weakening of urinary sphincters, which causes uncontrolled allocation of small portions of urine when coughing or while sleeping. Usually, bladder disorders are mild.
- The patient is often complaints of poor gastric activity, sharply reduced sexual potency .
Appearance of tabular crises
With dorsal dryness, there are tabular crises:
- In the area of the stomach, the patient has painful attacks of , which resemble pain in case of an ulcer. Acute colic in the stomach accompanied by vomiting. The patient does not eat anything, is lying down. He needs to provide complete peace. The patient should not make unnecessary movements, as the attack of pain and vomiting comes back. The duration of such attacks ranges from one week to two.
- In the larynx are expressed in choking and cramps when coughing.
- In the heart of , in nature, resemble angina, in the liver - cholelithiasis. Kidney pain is stitching.
- In the bladder, is expressed in acute painful attacks in the area of the urethra and bladder.
- Special mention should be made of gross violations in the field of view of .Their significance is extremely important, since they serve as early symptoms of
.To number of visual disturbances it is possible to carry a miosis, anisocoria, change of the form of pupils. A special manifestation is the symptom of Argyll Robertson. Visual disorders are noted in one fifth of all cases. - The disease affects and auditory nerves .The hearing falls sharply. In some cases, there are neurological manifestations such as ptosis, strabismus and diplopia. Such phenomena are unstable.
- The trophic disorders of include general weight loss, the skin becomes thin, and the patient has alopecia. Teeth crumble and fall, ulcers appear in the area of the foot and arthropathies, which do not cause pain.
- In the modern world, such a manifestation of the disease as pitting of foot and arthropathy of are extremely rare.
- Mental disorders are minor .Often, symptoms of progressive paralysis can be noted. In this case, it is customary to talk about the tabo-paralysis. They are not a frequent manifestation of this disease, but medicine notes cases of central and peripheral paralysis.
Diagnosis of the disease is the first step to the successful treatment of
The main indicator in the diagnosis is the clinical picture.
The patient should be examined by a neurologist and an ophthalmologist. Magnetic resonance therapy is strongly indicated. A thorough analysis of the cerebrospinal fluid for the content of the causative agent of syphilis is carried out.
In spinal fluid, as a rule, a slight increase in protein is recorded. The reactions of Wasserman, RIF( reaction of immunofluorescence) are noted. The Lange curve has a paralytic character.
The main approaches to the treatment of
The main principle of treatment of the brain is the antisyphilis therapy , which requires intensive use of medicines: penicillin, mercury, bismuth, iodine.
Treatment has a course character. The course during the first two years of the year is repeated 6 times, in the next two years 4 times, and then reduced to one course per year.
For crises, it is undesirable to prescribe as an analgesic for morphine promedol and other narcotic drugs, since their use can cause the effect of dependence.
Generally, instead of morphine, pyrotherapy is performed. It is prescribed injections of vitamin B1, irradiation of the spinal cord. In extreme cases, the procedure of chordatemia is indicated.
In ataxia, a set of gymnastic exercises is prescribed. Their goal is to teach the patient with the help of vision control and walk through the floorboard with the help of a stick or, falling in a lying position, to fall with the toe of the foot at certain points indicated on the board.
The patient should be able to raise and lower his leg, get a heel of one leg in the knee of the other.
Ataxia is widely used for lower limb massage sessions. Well-proven electrophoresis, contrasting water procedures, subcutaneous injections of strychnine.
If you touch a serious complication of arthropathy, then the treatment should appoint a surgeon or orthopedist.
For patients with dry conditions, resorts with a warm climate are suitable.
Severe complications of
There are such undesirable satellites as pielit, infection of blood and pressure sores, chronic cystitis. The patient may lose sight.
The cardiovascular system is affected. Sometimes true paralysis develops.
Forecast of
The shorter the incubation period from the moment of infection with syphilis to the first symptoms of the disease, the more disappointing the forecast becomes.
The chances of recovery in this case are negligible or there is no at all.
If the disease has taken a benign form, then it is possible to keep working capacity for many years.
But with a malignant course of the disease with such grossly growing neurological manifestations as ataxia and tabetic cachexia, it is almost impossible to improve one's health.
It can be said that medicine has not invented any effective drugs for the treatment of this terrible disease. But nevertheless, some 
ways of alleviating the situation of the patient are available. In the case of early recognition of the disease, it is possible to create conditions suitable for the patient's condition.
This can mitigate the manifestations of the disease and make the patient's quality of life better.
Spinal cord has a chronic form of the flow. The duration of the disease is 30 years and more. The course of the disease involves three stages.
Spinal cord triad:
- Neurological , characterized by a lesion of the posterior roots of the spinal cord.
- Ataxic , with its inherent impairments in the musculo-articular apparatus.
- Paralytic , in which manifestations of ataxia are so deep that the diseased person is deprived of the opportunity to move.
Doctors say that the disease of neurosyphilis is a very complex disease. It destroys the whole organism.
