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July 1937

COMBINED SYSTEM DISEASE IN TABES DORSALIS

Author Affiliations

NEW YORK

From the Neurological Division and Neuropathological Laboratory of the Montefiore Hospital.

Arch NeurPsych. 1937;38(1):43-61. doi:10.1001/archneurpsyc.1937.02260190053004
Abstract

The clinical manifestations and pathologic observations in tabes dorsalis are too well known to be discussed in this presentation. A combined lesion of the posterior columns and pyramidal tracts, giving the cord the appearance of subacute combined degeneration, although described, is less frequently observed. The pathologic lesions in a number of cases described in the literature as instances of tabes in combination with involvement of the lateral tracts were due to syphilitic or arteriosclerotic vascular disease, to inflammatory or other diseases of the spinal cord or to descending degeneration from lesions above the spinal cord. A careful survey of the clinical features shows that many are not clearcut cases of tabes. The question arises whether the pathologic changes in the pyramidal pathways can be attributed to the same process that causes the destruction of the posterior columns. In five of a series of fifteen cases of tabes dorsalis in which

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