Spinal dryness (synonym: tabes dorsalis, progressive locomotor ataxia, spinal cord , dry) is a late form of neurosyphilis. Spinal cord develops after a few, sometimes many years after infection with syphilis in cases of untreated or insufficiently treated syphilis. Histologically, degenerative phenomena and atrophy of the fibers of the posterior roots and posterior columns of the spinal cord are determined. Early symptoms of dorsal arteries are acute shooting pains and paresthesias (see Sensitivity ), numbness of the legs, crawling sensation, etc. Pain usually does not have a certain localization, is noted in different parts of the body, intensified at night and before bad weather. During the same period, hypoesthesia (decreased sensitivity) is noted in the zone innervated by the roots of the thoracic spinal cord.
Dorsal dryness is characterized by tabular visceral crises - severe pain in the internal organs with a violation of their function. In this case, more frequent gastric crises (severe shooting pain in the epigastric region, vomiting , sometimes with blood), heart rhythms, simulating angina .The
There is a gross violation of vibrational and muscular-articular sensitivity, spinal ataxia (see). The gait is typical: the patient widely arranges legs at walking and with force strikes a heel on a floor ("stamping gait").
In the Romberg pose, instability (see Romberg symptom ). Early decrease in tendon reflexes, until complete absence; earlier drop out knee and Achilles reflexes. Develops a sharp hypotension of the muscles, leading to looseness in the joints; sometimes patients can not walk.
The most characteristic sign of dorsal dryness is the symptom of Argyl Robertson (the absence of pupillary reaction to light, while maintaining accommodation). There are also trophic disorders (arthropathies, trophic ulcers on the lower limbs, tooth loss, nail defects, local hair loss), as well as impaired pelvic organs (delay or incontinence, lack of urgency), and sexual weakness develops. Sometimes patients experience delusions, hallucinations, and memory loss . In cerebrospinal fluid - cytosis, increase in protein content, increased blood pressure, positive serological reactions .
Spinal cord may be complicated by signs of progressive paralysis .
Differentiate should be with Friedreich's ataxia, with polyneuritis . The diagnosis is based on anamnestic data, positive serological reactions, the symptom of Argyl Robertson. In a number of cases, the disease develops slowly, the patients are able to work for many years; in severe cases, the disease after 5-6 years ends lethal.
Treatment - antisyphilitic, repeated courses of preparations of bismuth with penicillin (5 courses with a break from 1 to 4 months). At the same time, they are treated with vitamins ( B1 , C). When pain is prescribed analgesics ( amidopirin , analgin, etc.), heat. Balneological treatment is shown, for example, hydrogen sulphide baths, spa treatment in Pyatigorsk , Sochi, Tskhaltubo and others.