Resumen

PEREZ MAS, Aida; LICOR HERNANDEZ, Georgina  y  RODRIGUEZ SANCHEZ, Yamila.   Tabes dorsalis: A case report. AMC [online]. 2006, vol.10, n.4, pp.123-131. ISSN 1025-0255.

Neurosyphilis, which impairs the central nervous system through the Treponema pallidum, presents symptomatically in 7 % of patients with syphilis. Tabes dorsalis in included in the parenchymal forms of neurosyphilis. Such a myeloneuropathy develops 10 to 30 years after the onset primary syphilitic infection. Typically it is described as a clinical triad that involves acute lighting pains, ataxia and urinary disorders. The most frequent findings upon medical examination are pupillary disorders (Argyll Rubertsons pupilla) lower extremity osteotendonous areflexia, positive Rombergs sign, early loss of vibratory and position sense (palestesia and batiestesia arespectively. Cefalorachidial fluid findings are nonspecific, VDRL serology of cefalorachidial fluid confirms the diagnosis. Treatment is based on high crystalline penicillin. Response to treatment varies. Neurologic manifestations may come back or progression of symptoms may be stopped. Criterium for healing relies on bringing back to normal the cephalorachidial fluid for 2 years. This paper reports on a white, male patient, aged 72, who presented with walking disorders characterized by loss of balance for the previous 7 days, blurred vision, and urinary retention. Upon medical examination it was found an increase in the sustaining base, positive Romberg sign, Kneepan and ankle areflexia. VDRL blood serology tested reactive 1:32 and cephalorachidial fluid VDRL tested reactive 1:2. The patient was treated with penicillin for 2 weeks. Clinical manifestation were reverted.

Palabras clave : TABES DORSALIS; NEUROSYPHILIS; CEREBROSPINAL FLUID; SEROLOGY; PENICILLINS [therapeutic use].

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