Tabes dorsalis in the 19 century. The golden age of progressive locomotor ataxia.

Rev Neurol (Paris)

Center for Brain and Nervous System Disorders, Genolier Swiss Medical Network and department of neurology and neurorehabilitation Clinique Valmont, Glion, Switzerland. Electronic address:

Published: April 2021

Tabes dorsalis, a late neurological complication of syphilis, is nowadays almost extinct. The path to understanding this disease and its pathophysiology was long and winding, spanning multiple centuries. The 19 century was a crucial period for understanding it. In the first third of the century, German and French physicians defined the semiology of tabes dorsalis, renamed in France "ataxie locomotrice progressive [progressive locomotor ataxia]." Nevertheless, the multiplicity of ancient and recent terms and the description of sometimes unclear nosological concepts (tabes nervosa, tabes spasmodic, nervo-tabes, etc.) were a hindrance to understanding it. Tabes dorsalis was a fertile ground for the description of many clinical signs that have become classics in medicine. No real treatment was available and various unusual therapies were performed. For a long time, the etiology of this disease remained unknown. The link between syphilis and tabes dorsalis was slowly established in the second part of the 19 century from epidemiologic observations. We present an overview of the concept of tabes dorsalis in the medical context of the 19 century and discuss the medical observations of some famous patients suffering from the disease such as Édouard Manet (1832-1883) and Alphonse Daudet (1840-1897).

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http://dx.doi.org/10.1016/j.neurol.2020.10.006DOI Listing

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