July 28, 2014
A 55-year-old man with bilateral upper extremity numbness and decreased sensation on neurological examination
Tabes Dorsalis
- The incidence of neurosyphilis is on the rise, partly due to increased longevity of patients with acquired immunodeficiency syndrome (AIDS).
- Tabes dorsalis is usually seen in partially treated or untreated patients 20–30 years after primary syphilis infection, as in this case.
- The diagnosis of neurosyphilis is based on clinical grounds, CSF findings, and serologic evidence.
- Key Diagnostic Features: Posterior column T2 hyperintensity is seen.
- DDx: Subacute combined degeneration (Vitamin B12 deficiency), multiple sclerosis, HIV myelopathy, nitrous oxide abuse, copper deficiency, and sarcoidosis
- Rx: Limited. Penicillin.
