Clinical features

The clinical features of tabes dorsalis include:

• sensory changes:
  • lightning pains:
    • often the earliest symptom
    • typically in the calf or ankle
  • loss of proprioception and vibration sense
• optic atrophy
  
  
• ataxia:
  • due to defective proprioceptive and spinocerebellar sense
  • Romberg positive
    
    
• reflexes:
  • tendon reflexes are absent in the legs
  • plantars are often upgoing
  • abdominal reflexes may be exagerated
    
    
• Argyll-Roberson pupils are common
  
  
• bladder dysfunction may occur, rarely causing atonic bladder
  
  
• there may be ptosis