Locomotor ataxia, also known as tabes, is an affected on of the spinal cord, and although much more is known about the disease to day than ever before, yet since 1847 it has had its present name.
The particular portion of the cord which controls the muscle sense is diseased, and it is not until very late in the trouble that losses of power are apparent. Men are more often afflicted than women, an*d most of the cases occur between the ages of thirty and forty .five.
The venereal disease of syphilis is responsible for about three fourths of all the cases, and mental worry or shock, blows on the spine, falls, overwork, exposure to cold or storms, excessive use of stimulants and tobacco, and sexual abuses, are the cause of the remainder.
Symptoms. What are known as the three cardinal or chief symptoms of locomotor ataxia are loss of the patella tendon reflex, the reaction of the pupil of the eye, known as the Argyll Robertson pupil, and the swaying symptom known as the Romberg sign.
The first is the absence of the usual sharp jerk to the leg, which occurs in healthy persons when the tense tendon or cord just below the knee pan is sharply tapped, if the leg is at a right angle to the thigh. The second is absence of reaction of the pupil to light. In a healthy person the pupil dilates and contracts to both accommodation (or distance) and to light, while in this disease it only responds to the first.
The swaying symptom is noticed if a patient affected tries to stand with heels together and his eyes closed. While he will be unaffected if they are open, as soon as he closes them he sways violently and many times will fall. Other symptoms are pains in the calves of the legs and stomach, which shoot with lightning rapidity through these organs. There occur tingling and burning sensations about the head, neck, and extremities, shuffling gait, due to the loss of that sense which tells what position the feet are placed in, and requiring the eyes to be on the ground to prevent the patient from falling down. Disturbances of vision occur, and later a general weakness of the body from lack of sufficient exercise.
While a cure cannot be promised or expected, yet the disease may be arrested and controlled to a greater or less degree and its extension limited to slow progress.
Treatment. Iodide of potash should always be tried in every case and under a physician's direction, as the time lost in experimenting can never be regained. Beginning with ten grains three times a day, rapidly increase to the point where the system is saturated, and then continue at this point for some time. Mercury, either by the mouth or rubbed into the skin, is a useful addition.
For the relief of pain, phenacetine or some other anodyne preparation will have to be given, though morphine should be avoided, unless absolutely necessary, owing to the liability, as in any chronic disease, of acquiring a habit.
Bromide of potash in doses of ten to thirty grains may be given to quiet the nerves.
Proper exercises, not carried to the point of fatigue, massage of the muscles, hot baths and electricity, all have their place and prove useful.
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