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Spinal cord lesions
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
v – Tabes dorsalis occurs because of the degeneration of dorsal columns and is seen in tertiary syphilis. As a result, impaired proprioception and locomotor ataxia are evident in these patients. Other symptoms and findings associated with tabes dorsalis include Argyll Robertson pupils (reactive to accommodation but not to light), a positive Romberg’s sign and sensory ataxia at night.
Infections
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Neurosyphilis (see Chapter 12) comprises meningitis, tabes dorsalis, and general paralysis of the insane (GPI). The meningovascular inflammation is an example of endarteritis obliterans, and can cause ischaemic cerebral lesions. There may also be small meningeal gummata. Tabes dorsalis is a degeneration of the posterior spinal columns and dorsal nerve roots; it results from chronic inflammation of the nerve roots. GPI is a cerebral atrophy characterized by loss of neurons, a microglial cell reaction, and visible spirochaetes in the tissues.
100 MCQs from Dr. Guy Molyneaux and Colleagues
Published in David Browne, Selena Morgan Pillay, Guy Molyneaux, Brenda Wright, Bangaru Raju, Ijaz Hussein, Mohamed Ali Ahmed, Michael Reilly, MCQs for the New MRCPsych Paper A, 2017
Dr Pauline Devitt, Dr Angela Noonan, Dr Klaus Oliver Schubert, Prof Finian O’Brien
A 60-year-old man presents with severe stabbing pains in his legs lasting a few seconds. He walks with a wide-based and stomping gait. On neurological examination, there is absence of proprioception and vibration sensation in the lower limbs. Assuming the diagnosis is tabes dorsalis, which of the following clinical or pathological findings are least likely to be found in this patient?
Instruments in the history of the clinical neurosciences: Dedicated to James M. Edmonson, Ph.D., mentor, colleague, and friend
Published in Journal of the History of the Neurosciences, 2019
Jim, a world-renowned authority on the history of medical instruments, welcomed my enthusiasm and began gently educating me about how instruments were made in the nineteenth century. He showed me some artifacts in the Dittrick collection, including a range of reflex hammers, and introduced me to important primary sources for learning about medical instruments of the nineteenth and early-twentieth centuries, not least of which were ephemera such as the catalogues of instrument makers. He also gave me specific examples in which instruments played an important role in the development of medical specialties, and of the interactions between clinicians and instrument makers, and some specific examples of instrument fads and their impact (typically negative) on clinical progress (e.g., Perkins’s “patent metallick Tractors” for pain and other ailments, and gastric freezing for peptic ulcer disease) (Edmonson, 1989). Jim and I subsequently wrote a paper together entitled “The Suspension Treatment for Tabes Dorsalis: A Case History of a Therapeutic Fad” (Lanska and Edmonson, 1990). Jim and I have been friends ever since, a friendship that spans a full three decades. His influence led to a series of papers on neurological instrumentation (e.g., Lanska and Lanska, 1990; Lanska, 1995a, 1995b, 1997, 1999a, 1999b, 1999c, 2000a, 2000b, 2001, 2002a, 2002b; Lanska and Dietrichs, 1998; Lanska et al., 2001a, 2001b), some with various colleagues, and ultimately to the 2018 ISHN Symposium.
Synergies and Motor Equivalence in Voluntary Sway Tasks: The Effects of Visual and Mechanical Constraints
Published in Journal of Motor Behavior, 2018
Mariusz P. Furmanek, Stanisław Solnik, Daniele Piscitelli, Omid Rasouli, Ali Falaki, Mark L. Latash
When visual information is unavailable(e.g., when a person stands with eyes closed, sensory signals of other modalities become highly important. Earlier In the XX-th century, untreated syphilis could lead to a state called tabes dorsalis, characterized by disrupted transmission of sensory signals along the dorsal columns of the spinal cord. Those patients could only stand with their eyes open. Similar observations have been made in patients with peripheral sensory problems caused by advanced stages of diabetes and by large-fiber peripheral neuropathy (Sanes, Mauritz, Dalakas, & Evarts, 1985; van Deursen & Simoneau, 1999). The importance of proprioceptive information is also demonstrated by so-called vibration-induced fallings during the application of high-frequency, low-amplitude muscle vibration to leg muscles (Eklund & Hagbarth, 1967; Roll & Vedel, 1982).
Gabrielle Lévy and the Roussy-Lévy syndrome
Published in Journal of the History of the Neurosciences, 2018
At the lower extremities, the extensor of the hallucis longus was paretic, in particular on the right side and “the antero-extern group on the left.” Areflexia was found at all tendon reflexes. No cerebellar signs. Sensory examination was normal “for all modalities: touch, hot prick, cold, position sense, stereognosis.”28A tous les modes: tact, piqûre chaud, froid, sens des attitudes, stéreognosies. A certain Mrs. De Brancas performed the electric examination which showed “very remarkable faradic and galvanic hypoexcitability, predominantly at the level of the small extremity muscles.” Two of Berthe’s children (Simone, 7 years old and Raymond, 2s year old; III-1 and III-2 in Figure 5b) and her sister Julia Ur… (II-2 in Figure 5b) suffered from the same disease. Raymond (Figure 6) walked like “un petit tabétique” [a small tabetic; at the time this usually indicated a sensory ataxic gait as seen in syphilitic tabes dorsalis].