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What is Tabes Dorsalis?

D. Jeffress
D. Jeffress

Tabes dorsalis is a potentially debilitating condition that affects the brain, spinal cord, and nerves throughout the body. It occurs when a syphilis infection goes untreated for several years. People with the disorder can experience a loss of touch sensation and reflexes, poor coordination, and sharp, sudden muscle pains. Major complications such as dementia and paralysis can set in if treatment is not sought. Medications such as penicillin can usually prevent tabes dorsalis from worsening, but any damage that has already been done to the nervous system prior to treatment cannot be repaired.

Thanks to better patient education and modern testing procedures, syphilis infections are usually caught and treated long before the onset of tabes dorsalis. Syphilis can remain latent or inactive in the body for several decades, however, and a person may not experience suspicious symptoms that prompt testing until nerve damage has already begun. In most cases, tabes dorsalis symptoms appear about 20 to 30 years after the initial syphilis infection.


Complications first arise when the infection enters the dorsal columns of the spinal cord in the upper back. The dorsal columns contain nerves that provide sensory feedback to the brain. Syphilis can cause nerve inflammation in the region that slows or completely prevents normal functioning. Without treatment, nerve problems extend from the dorsal region to the rest of the spinal cord and the brain.

Early symptoms of tabes dorsalis typically include weakness, fatigue, and slowed reflexes. A person might develop an uncoordinated gait with very heavy steps due to poor sensory perception. Shooting pains in the back and legs are common as nerve damage worsens. Bladder incontinence, sexual dysfunction, and impaired motor skills are possible as well. The disease can also affect vision and hearing and lead to mental problems, such as major personality changes. Dementia, blindness, and paralysis may arise within months or years of the onset of symptoms.

Blood work, imaging scans, and nerve tests are needed to confirm a tabes dorsalis diagnosis. Doctors check for the presence of syphilis and try to determine the extent of nervous system damage. Penicillin is usually administered right away in hopes of destroying the existing infection. Other drugs and hospital therapies might be needed to deal with pain, mental issues, and vision problems.

After receiving medical care, patients usually need to attend physical therapy sessions to improve coordination and muscle control. Permanent nerve damage means that some people are unable to overcome their difficulties with walking and performing other physical tasks. Support groups and psychological counseling can help recovering patients better understand their conditions and learn how to enjoy life despite their disabilities.

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