Spinal the " dryness"

Spinal the " dryness " (a synonym: tabes dorsalis, progressive locomotor ataxia, the " dryness" of the spinal cord) - late form of neurosyphilis. Spinal the " dryness " is developing several, sometimes many years after infection with syphilis in cases of untreated or inadequately treated syphilis. Histologically determined degenerative phenomena and atrophy fibers posterior roots and rear pillars of the spinal cord. Early symptoms of spinal suchocki are sharp shooting pain and paresthesia (see Sensitivity), it is noted numb legs, the feeling of crawling, etc., Pain usually do not have a specific localization, celebrated in different parts of the body, strengthen at night and in front of the bad weather. In the same period, noted hypoesthesia (less sensitive) in the zone, innerved roots thoracic section of the spinal cord.
For spinal suchocki characteristic tablichka visceral crises - severe pain in the internal organs with a violation of their functions. This is often gastric crises (severe shooting pain in podlojecna area, vomiting, sometimes with blood, heart attacks, simulating angina.
Notes gross violation of vibration and muscular-articular sensitivity, spinal ataxia (see). Typical gait: the patient wide stance when walking and force strikes heel on the floor ("press"walk).
In the Romberg - instability (see Romberg symptom). Early indicate reduced tendon reflexes, and even lack; before the fall of the knee and Achilles reflexes. Develops sudden hypotension muscles, leading to resultante in joints; sometimes patients can't walk.
The most common symptom of spinal suchocki is a symptom of Argyll Robertson (no reaction of pupils to light when saving of accommodation). There are also trophic disorders (arthropathy, trophic ulcers of the lower extremities, loss of teeth, defects nails, local hair loss), as well as violations of pelvic organs functions (delay or urinary incontinence, lack of appetite), develops sexual weakness. Patients sometimes there is delirium, hallucinations, memory loss. In the cerebrospinal fluid - lymphocytosis, increased protein, high blood pressure, a positive serological test.
Spinal the " dryness " may be complicated by the signs of progressive paralysis.
Should differentiate with ataxia, with the polyneuritis. The diagnosis is based on historical data, a positive serological reactions, symptoms of Argyll Robertson. In some cases, the disease develops slowly sick for many years of working; in severe cases of the disease in 5-6 years ends lethally.
Treatment - protevoepilepticescoe, repeated courses of drugs bismuth with penicillin (5 courses with a break from 1 to 4 months). At the same time treatment with vitamins (B1, C). In case of pain syndrome prescribe analgesics (amidopyrine, analgin and others), warmly. Shown balneological treatment, such as hydrogen sulfide baths, Spa treatment in Pyatigorsk, Sochi, Tskaltubo and other