A 52-year-old man with a history of untreated syphilis presents with progressive gait instability and lightning-like pains in both legs over 3 months. Vital signs: BP 145/92 mmHg, HR 78/min, RR 16/min, Temp 37.2°C. Examination reveals positive Romberg sign, loss of vibration sense in lower extremities, and Argyll Robertson pupils. CSF VDRL is positive. He denies visual complaints. Which of the following is the most likely diagnosis?
- A)Subacute combined degeneration
- B)Guillain-Barre syndrome
- C)Amyotrophic lateral sclerosis
- D)Myasthenia gravis
- E)Tabes dorsalisGABARITO
Explicação
Tabes dorsalis is the correct answer because neurosyphilitic degeneration of the dorsal columns and dorsal roots causes sensory ataxia, loss of vibration sense, lightning pains, and Argyll Robertson pupils. Ver explicação completa e trilha adaptativa →