Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case historiesSouthard, Elmer Ernest
Science
Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case histories
Southard, Elmer Ernest
Neurosyphilis
=TABOPARETIC NEUROSYPHILIS (“taboparesis”) is CLINICALLY a
combination of the symptoms of TABES DORSALIS and those of GENERAL
PARESIS. The COURSE of TABOPARESIS is likely to be from a
characteristic tabes dorsalis (often of years’ standing) to a
characteristic general paresis; the ultimate paretic picture is
likely to retain various characteristics of tabes. The LABORATORY
TESTS in the paretic phase are characteristic of ordinary
(non-tabetic) general paresis. The PROGNOSIS, after the paretic
phase has arrived, is apt to be that of general paresis.=
=Case 16.= Joseph Sullivan, a waiter, 50 years of age, sought assistance
at the Psychopathic Hospital voluntarily. His complaint of severe and
lancinating pains in the legs, difficulty with his gait, and a feeling
of constriction about the waist, was forthwith suggestive of tabes
dorsalis. He was a rather poorly nourished, white-haired man, with a
drooping of the left side of the face. The pupils reacted sluggishly to
light, the right somewhat better than the left. A marked Romberg
reaction could be demonstrated. Ataxia in walking was marked. There was
some incoördination of the hands, considerable tremor, and writing was
poorly performed. The ankle-jerks and knee-jerks were absent. On the
whole, the diagnosis of TABES DORSALIS was clear enough.
The most appealing situation was =mental=. Sullivan was exceedingly
apprehensive about his condition on the ground that it was growing
progressively worse; if it was to get worse, Sullivan feared he would
commit suicide. From his own account, he had become irritable,
quick-tempered, and often unreasonable. As usual in these cases, the
question arose whether the depression was psychopathic or natural.
=TABETIC SYMPTOMS AND SIGNS IN ORDER OF THEIR FREQUENCY=
=ANALYSIS OF 250 CASES=
PER CENT
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