Mielorradiculopatia esquistossomótica

Silva, Luciana Cristina dos Santos; Maciel, Pedro E.; Ribas, João Gabriel Ramos; Pereira, Sílvio Roberto de Sousa; Serufo, José Carlos; Andrade, Luciene Mota; Antunes, Carlos Maurício de Figueiredo; Lambertucci, José Roberto

doi:10.1590/s0037-86822004000300013

Cited by 33 publications

(46 citation statements)

References 74 publications

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“…The asymptomatic form of NS is far more frequent than the symptomatic ones 16,46,54,56 . All the symptomatic forms of NS are more prevalent among young men which can be partly explained by the fact that the incidence of schistosomiasis is usually higher in males who in rural areas are more likely to be exposed to schistosome-infected water during childhood and in the course of their work 16,54 .…”

Section: Clinical Syndromesmentioning

confidence: 98%

“…Portopulmonary anastomoses through the azygos veins allow ova and adult schistosomes to reach the lungs and ova laid there could enter pulmonary veins and become arterial emboli 54 . In summary, it is believed that the deposition of S. mansoni ova in the brain is more common in the hepatosplenic form of schistosomiais mansoni, although the clinical manifestations are quite rare in this situation and the deposition of S. mansoni ova may occur in any form of the disease 56 .…”

Section: Pathogenesismentioning

confidence: 99%

“…The most common site of clinically significant NS is the spinal cord 9,12,13,54,56 . The prominent lateral spine of S. mansoni's egg probably hampers the egg from reaching the brain 9,16 .…”

Section: Pathogenesismentioning

confidence: 99%

“…All the symptomatic forms of NS are more prevalent among young men which can be partly explained by the fact that the incidence of schistosomiasis is usually higher in males who in rural areas are more likely to be exposed to schistosome-infected water during childhood and in the course of their work 16,54 . Patients' ages have ranged from one to 82 years (mean 26 years or 37 + 16 years in different studies) 33,35,54,56 . Schistosomal myelopathy tends to occur early after infection and is more likely to be symptomatic than cerebral schistosomiasis 9 .…”

Section: Clinical Syndromesmentioning

confidence: 99%

“…Schistosomal myelopathy tends to occur early after infection and is more likely to be symptomatic than cerebral schistosomiasis 9 . The clinical syndrome of spinal NS is usually an acute or subacute myelopathy, with or without polyradiculitis, causing lumbosacral and lower limbs pain, paraparesis or paraplegia, bowel and bladder sphincter dysfunction, and sensory, sexual and reflexic disturbances 42,46,54,56 . In a review by FERRARI 13 , 99% of the patients present with leg weakness, 85% with decreased sensation in the lower thoracic dermatomes, 66% with decreased sensation in lumbar dermatomes, 71% with low back or leg pain, and 90% with bladder dysfunction; 31% of the patients have mostly medullary involvement, with a clinical picture of transverse myelitis; 14% have isolated involvement of the conus medullaris and cauda equina; and 56% have myeloradiculopathy or a combination of myelitis with conus and cauda equina syndrome.…”

Section: Clinical Syndromesmentioning

confidence: 99%

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Neuroschistosomiasis due to Schistosoma mansoni: a review of pathogenesis, clinical syndromes and diagnostic approaches

Nascimento‐Carvalho

Moreno-Carvalho²

2005

Rev. Inst. Med. trop. S. Paulo

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SUMMARYNeuroschistosomiasis (NS) is the second most common form of presentation of infection by the trematode, Schistosoma mansoni. Granulomatous inflammatory reaction occurs as a result of schistosome eggs being transmitted to spinal cord or brain via the vascular system, or by inadvertent adult worm migration to these organs. The two main clinical syndromes are spinal cord neuroschistosomiasis (acute or subacute myelopathy) and localized cerebral or cerebellar neuroschistosomiasis (focal CNS impairment, seizures, increased intracranial pressure). Presumptive diagnosis of NS requires confirming the presence of S. mansoni infection by stool microscopy or rectal biopsy for trematode eggs, and serologic testing of blood and spinal fluid. The localized lesions are identified by signs and symptoms, and confirmed by imaging techniques (contrast myelography, CT and MRI). Algorithms are presented to allow a stepwise approach to diagnosis.

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Section: Clinical Syndromesmentioning

confidence: 98%

Section: Pathogenesismentioning

confidence: 99%

Section: Pathogenesismentioning

confidence: 99%

Section: Clinical Syndromesmentioning

confidence: 99%

Section: Clinical Syndromesmentioning

confidence: 99%

See 3 more Smart Citations

Neuroschistosomiasis due to Schistosoma mansoni: a review of pathogenesis, clinical syndromes and diagnostic approaches

Nascimento‐Carvalho

Moreno-Carvalho²

2005

Rev. Inst. Med. trop. S. Paulo

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Conus medullaris neuroschistosomiasis mimicking Guillain–Barre syndrome: A case of delayed diagnosis leading to permanent neurological damage

Aljuma'ai,

Ghabisha,

Ahmed

et al. 2024

Clinical Case Reports

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Key Clinical MessageIn the evaluation of acute flaccid paralysis, particularly in pediatric populations within endemic areas for schistosomiasis infection, clinicians must maintain a high index of suspicion for neuroschistosomiasis. Prompt identification is imperative to mitigate the risk of irreversible neurological sequelae.AbstractSpinal cord involvement in neuroschistosomiasis (NS) is considerably rare, with even fewer reported cases affecting the conus medullaris in children. While NS's neurological sequelae are typically thought to be reversible, delayed diagnosis and treatment can lead to permanent deficits. We report a case of a 9‐year‐old boy who presented with 3 weeks of progressive bilateral lower extremity weakness. A spinal MRI showed patchy gadolinium enhancement in an expanded conus medullaris, leading to a presumed diagnosis of Guillain–Barre syndrome, and the patient was treated with intravenous immunoglobulin. However, the lack of improvement necessitated surgical laminectomy. The post‐operative histopathological examination confirmed the presence of a schistosomal parasite. Despite initiating therapy with corticosteroid and praziquantel, the patient did not exhibit clinical improvement, resulting in persistent flaccid paralysis, bladder, and bowel incontinence. In conclusion, spinal NS should be considered in patients presenting with myeloradicular symptoms in regions endemic for schistosomal infection, as delayed recognition can result in irreversible outcomes.

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Medullary neuroschistosomiasis in adolescence: case report and literature review

et al. 2021

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Mielorradiculopatia esquistossomótica

Abstract: RESUMO A mielorradiculopatia esquistossomótica é a forma ectópica mais grave e incapacitante da infecção pelo

Cited by 33 publications

References 74 publications

Neuroschistosomiasis due to Schistosoma mansoni: a review of pathogenesis, clinical syndromes and diagnostic approaches

Neuroschistosomiasis due to Schistosoma mansoni: a review of pathogenesis, clinical syndromes and diagnostic approaches

Conus medullaris neuroschistosomiasis mimicking Guillain–Barre syndrome: A case of delayed diagnosis leading to permanent neurological damage

Medullary neuroschistosomiasis in adolescence: case report and literature review

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