Epidemiological aspects in neuroschistosomiasis

Vidal, Cláudio; Gurgel, Fernando; Ferreira, Maria Lúcia Brito; Filho, Hildo Rocha Cirne de Azevedo

doi:10.1590/s0004-282x2010000100016

Cited by 12 publications

(14 citation statements)

References 9 publications

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“…These data reflect the urbanization process of schistosomiasis 14 . It is possible that the immune status before, during and after the development of the infection is the most important factor in determining the clinical forms of Schistosomiasis mansoni 3 .…”

Section: Discussionsupporting

confidence: 60%

“…Recent first-time exposure to contaminated waters among these patients could make them more susceptible towards developing a favorable immunological environment for promoting neurological damage. This differs from individuals who have been living in long-standing endemic zones for schistosomiasis, in which the contamination sometimes affects several generations of the same family 2,3,14 . This paradigm may explain the major spinal cord abnormalities observed in this sample and may represent a state of immunological hypersensitivity to the antigens and eggs of the worm.…”

Section: Referencesmentioning

confidence: 93%

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Extensive spinal cord involvement in magnetic resonance imaging evaluation on schistosomal myelitis

Vidal¹,

Ferreira²,

Filho³

et al. 2012

Arq. Neuro-Psiquiatr.

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Schistosomiasis is a serious public health problem in some regions of the world. It is endemic in more than 74 countries and accounts for the majority of the cases of portal hypertension among the young population in these areas. Around the world, it is believed that there are about 200 million people infected by the Schistosoma species S. mansoni, S. haematobium, S. japonicum, S. intercalatum and S. mekongi 1,2 .The temporal clinical and systemic forms of the disease are: acute (toxemic and non-toxemic), latent and chronic 2,3 . The latter is divided into mild forms (intestinal and hepaticintestinal) and severe forms (hepatosplenic, pulmonary and glomerular) 2,3 .The presence and clinical significance of neurological lesions depend on the combination of the presence of eggs in the nervous system and the immune response of the host. In the majority of cases, a type IV or granulomatous delayed immune response occurs, and the response is greater in the earlier phases of schistosomiasis. In chronic forms, it becomes localized and attenuated (immunological modulation phenomenon) 4,5 . ABSTRACTThe diagnosis of schistosomal myelitis (SM) is frequently presumptive because no findings from any complementary examination are pathognomonic for this disease. The present report describes some abnormalities seen on magnetic resonance imaging (MRI) evaluation of a series of SM patients and discusses their etiopathogenesis. Methods: This study evaluated SM patients at the time of their diagnosis. These patients routinely underwent MRI on all segments of the spinal cord. Results: Thirteen patients were evaluated. The MRI was abnormal in 12 (92.3%) of them. In 11 patients (84.61%), the damage reached two or more spinal segments. Conclusions: MRI was an important diagnostic aid in this sample, because of the high rate of abnormalities detected. The tissue damage observed on MRI was extensive in the majority of the patients.Key words: Schistosoma mansoni, neuroschistosomiasis, myelitis, magnetic resonance imaging, diagnosis. RESUMOO diagnóstico da mielite esquistossomótica é frequentemente realizado por presunção, não havendo achado de exame complementar que seja patognomônico à condição. O presente estudo descreve alterações presentes na avaliação desses pacientes pela técnica da ressonân-cia magnética e discute sua etiopatogênese. Métodos: O estudo avaliou pacientes com mielite esquistossomótica no momento do diagnós-tico, os quais foram submetidos, rotineiramente, à ressonância magnética de todos os segmentos medulares. Resultados: Foram avaliados 13 pacientes, sendo a ressonância magnética alterada em 92.3% dos casos. Em 11 pacientes (84.61%), o dano abrangeu dois ou mais segmentos espinais. Conclusões: A ressonância magnética espinhal foi um importante auxílio diagnóstico nessa casuística em virtude da alta taxa de alterações detectadas. O dano tecidual observado foi extenso na maioria dos pacientes.Palavras-Chave: Schistosoma mansoni, neuroesquistossomose, mielite, imagem por ressonância magnética, diagnóstico.

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Section: Discussionsupporting

confidence: 60%

Section: Referencesmentioning

confidence: 93%

Extensive spinal cord involvement in magnetic resonance imaging evaluation on schistosomal myelitis

Vidal¹,

Ferreira²,

Filho³

et al. 2012

Arq. Neuro-Psiquiatr.

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“…The transmission of the disease depends on whether the infected person is the definitive host, on whether water collection systems have inadequate sanitation and on whether a freshwater mollusk is the intermediate host. 1,2 This disease is endemic in Brazil, however in the south only northern Paraná is considered an area of endemic transition. 1 It is suggested that people living in non-endemic areas with little exposure to S. mansoni are more susceptible to the development of myelitis from this parasite.…”

Section: Introductionmentioning

confidence: 99%

Schistosomal Myeloradiculopathy in a Non-Endemic Area

Oliveira¹,

Kuzma²,

Costa³

et al. 2020

Rev. paul. pediatr.

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Objective: To report a schistosomal myeloradiculopathy case in a non-endemic area. Case description: A previously healthy 11-year-old boy, stricken by an acute loss of strength on his lower limbs, followed by a loss of strength on his upper limbs and upper body, associated with altered sensitivity of the vesical globe formation. The patient’s cerebrospinal fluid analysis showed eosinophilic meningitis, in addition to peripheral eosinophilia. The investigation resulted in a positive serology for Schistosoma mansoni. The treatment included steroids and praziquantel 60mg/kg, with a new dose after a month, as well as physical therapy for rehabilitation. The patient evolved with clinical improvement in the neurological exam, with a medullary section initially at C6, but now at T6. The patient is kept at prednisolone use (30mg/day) and longterm urinary catheter dependence. Comments: The schistosomiasis is endemic in many regions of Brazil; however, it has low incidence in the south of the country. Among its main manifestations, the schistosomal myeloradiculopathy is the most severe ectopic form of the disease, and should be suspected in patients with low back pain, strength and/or sensibility disorder of the lower limbs or urinary tract’s disturbance. Early diagnosis and treatment should be done in order to reduce severe neurological sequelae. Treatment includes schistosomiasis drugs, corticosteroids and/or surgery.

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“…Devido a grandes variações de expressão clínica, a prevalência da MRE em área endémi-ca ainda não é conhecida (Santos, Campos, Diniz, Leal, & Rocha, 2001;Vidal, Gurgel, Ferreira, & Azevedo Filho, 2010). A cada ano, o número de casos aumenta e há falhas no mapeamento e notificação da doença, esses fatores mascaram a realidade que proporcionam consequências graves para os infetados.…”

Section: Introductionunclassified

Efeitos da gameterapia na mielorradiculopatia esquistossomótica: Relato de caso

Carvalho¹,

Silva²,

Garção³

et al. 2014

Motricidade

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ARTIGO ORIGINAL | ORIGINAL ARTICLE RESUMOA esquistossomose mansônica é uma doença parasitária causada pelo helminto Schistosoma mansoni. A sua forma ectópica mais grave e incapacitante é a mielorradiculopatia esquistossomótica (MRE), caracterizada por atingir o sistema nervoso central. Atualmente, o uso da Realidade Virtual para o tratamento das sequelas de doenças neurológicas vem se desenvolvendo gradativamente. O objetivo deste estudo foi analisar a influência da Realidade Virtual (RV) sobre as funções neuromotoras de uma portadora de MRE. O estudo foi realizado com um indivíduo do sexo feminino, 30 anos de idade, com diagnósti-co clínico de MRE e sem experiência prévia com o Nintendo Wii ® ou similares. O procedimento de avaliação adotado visou à descrição e análise do comprometimento causado pelas afeções da MRE. A paciente foi avaliada, submetida à fisioterapia utilizando o Nintendo Wii ® e a plataforma Wii Balance Board ® que consistiu de 20 sessões com duração de 1 hora e frequência de três vezes por semana; após o tratamento a paciente foi reavaliada. Os resultados demonstraram que para a voluntária em estudo, a RV foi uma ferramenta eficaz na reabilitação neuromotora de MRE. Palavras-chave: terapia assistida por computador, neuroesquistossomose, modalidades de fisioterapia, esquistossomose mansoni ABSTRACT Schistosomiasis mansoni is a parasitic disease caused by Schistosoma mansoni. Its ectopic form most severe and disabling is the Schistosomal Myeloradiculopathy (SMR), characterized by reaching the central nervous system. Currently, the use of Virtual Reality for the treatment of neurological sequelae has been developing gradually. The aim of this study was to analyze the influence of Virtual Reality (VR) on neuromotor functions of a SMR carrier. The study it was carried out with a female subject, 30 years old, diagnosed with SRM and no preview experience with the Nintendo Wii ® or similar. The assessment procedure adopted aimed to describe and analyze the impairment caused by disorders of the MRE. Intervention program included a physical therapy program playing with the Nintendo Wii ® and Wii Balance Board ® platform (20 sessions lasting 1 hour and a frequency of three times per week). Subject was assessed before and after the intervention program. The results showed that the VR was an effective tool in neuromotor rehabilitation of SRM.

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Epidemiological aspects in neuroschistosomiasis

Cited by 12 publications

References 9 publications

Extensive spinal cord involvement in magnetic resonance imaging evaluation on schistosomal myelitis

Extensive spinal cord involvement in magnetic resonance imaging evaluation on schistosomal myelitis

Schistosomal Myeloradiculopathy in a Non-Endemic Area

Efeitos da gameterapia na mielorradiculopatia esquistossomótica: Relato de caso

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