Magnetic resonance imaging of the spinal cord in a man with tabes dorsalis

Abstract

Background

Tabes dorsalis is a late manifestation of untreated syphilis that is characterized by ataxia, lancinating pains, and urinary incontinence. A form of tertiary syphilis or neurosyphilis, it is the result of slow, progressive degeneration of the nerve cells in the spinal cord.

Method

Case report.

Findings

A 39-year-old man presented with tingling paresthesia in the lower limbs, difficulty in walking, and loss of vision. Magnetic resonance imaging (MRI) of the dorsal spine showed intramedullary hyperintensity and cord atrophy, similar to changes seen in subacute combined degeneration. MRI features of tabes dorsalis have not been described previously to the best of our knowledge.

Conclusion

MRI findings in this patient with tabes dorsalis were similar to those seen in subacute combined degeneration, which is characterized predominantly by cord atrophy and intramedullary hyperintensities.

Keywords:

• Tabes dorsalis
• Syphilis
• Myelitis
• Meningomyelitis
• Neurosyphilis
• Neuroimaging
• Spinal cord atrophy
• Optic atrophy
• Ataxia