Tabetic lightning pains: high-dosage intravenous penicillin versus carbamazepine therapy

The relief of tabetic lightning pains (LP) by carbamazepine (CBZ) was questioned as in some instances penicillin was given simultaneously. Only 1 out of 6 cases became pain-free on high-dosage intravenous penicillin, while CBZ rapidly abolished LP in those unresponsive to penicillin. Gastric crises were similarly abated by CBZ in 1 case under a placebo-controlled study. Inflammatory and degenerative changes in the posterior nerve root and ganglia may be the underlying pathologic basis that explains these two different responses to penicillin.

Tabes dorsalis progressing to general paresis after 20 years despite routine penicillin therapy

A man with a history of treatment for early syphilis presented with tabes dorsalis. Despite receiving a course of penicillin accepted as adequate by the World Health Organisation the illness progressed to tabo-paresis after 20 years. Reinfection cannot be excluded.

[Neurogenic arthropathies]

Are taken in examination the various causes of the neurogenic arthropathy. Are described the three main diseases which provoke a neurogenic arthropathy, that is the tabes, the hydrosyringomyelia, the diabetic neuritis. Are described arthropathy above all on the shoulder, on the Knee, and on the Foot. Are described five points for the precocious diagnosis of the disease.

[Paraplegia with a cauda equina syndrome due to stenosis of the spinal canal caused by tabes arthropathy]

The authors present a case of cauda equina paraparesis due to compression by tabetic osteo-arthropathy. Diagnosis was confirmed by the typical clinical picture of tabes and by the history of a chancre 53 years earlier. Radiography of the spine showed vertibral osteo-arthropathy. Opaque contrast myelography showed compression at the D 11/D 12 and L 4/L 5 levels, with poor contrast filling athe the L 1/L 3 level. Surgical treatment by decompressive laminectomies from D 12 to L 4 led to a satisfactory result with motor recovery and regression of the cauda equina syndrome.

Fractures in previously abnormal parts

This paper discussed fractures in defective or deformed bones, in stiff, wasted or anaesthetic limbs and at the ends of metal implants. Suggestions are made as to how treatment should be modified in these situations.

[Favorable effect of cingulotomy on gastric crisis pain]

Among the patients subjected to cingulotomy in the years 1969-1976 we observed a particularly interesting case of late syphilis with attacks of gastric crisis-type pains. Prolonged pharmacological treatment and subsequent surgery (laparatomy, chordotomy) as well as the use of large doses of narcotic drugs did not stop these attacks. The patient exhibited psychic disturbances such as emotional instability and aggressive behaviour. He had not been able to work and was granted a pension. Cingulotomy was performed and the attacks disappeared. During the six-year follow-up period the beneficial effects of the operation were preserved. There was no need to administer narcotic drugs. The patient's family and social life improved markedly.

[Postural hypotension in tabes dorsalis. Report of a case]

A case of postural hypotension in a patient with tabes dorsalis is reported. A polygraphic study of the arterial pression by intraortic catheterism, laboratory examinations and Minor test were made. As the results were negative for a disorder in the autonomic nervous system, it was concluded that the lesion responsible for the postural hypotension in the reported case was localizated in the aferent system of the baroreceptors.

'Oblongata' crises in tabes dorsalis

A patient in the pre-ataxic stage of tabes dorsalis suffered from gastric crises, but in addition had numerous episodes of apnoea and coma which in the older literature have been described as 'oblongata crises'--the presumption being that the crises are due to a brain stem disturbance.

[Tabic arthropathy from an orthopedic view-point (author's transl)]

28 patients, who were suffering of tabique alterations of joints, the time between infection and the first localisations and therapy are discussed. The differential diagnosis, as far as it is interesting the orthopadien physican, is explained.

Tabetic lumbar osteoarthropathy with cauda equina syndrome. Case report

The case is described of a 52 year old patient admitted for acauda equina compression syndrome (flaccid paraplegia of the lower limbs, bilateral lumbar and sciatic pains, urinary incontinence) of rapid onset and due to narrowing of the lumbar canal from tabetic arthropathy. These vertebral manifestations occur in a low percentage of tabetic arthropathies, which are relatively rare, and are not often accompanied by severe neurological disturbances. Decompressive laminectomy afforded rapid and lasting relief.