Involvement of central nervous system in the schistosomiasis

Ferrari, Teresa Cristina de Abreu

doi:10.1590/s0074-02762004000900010

Cited by 84 publications

(83 citation statements)

References 15 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%

“…The prominent lateral spine of S. mansoni's egg probably hampers the egg from reaching the brain 9,16 . The pathological findings include a granulomatous intramedullary mass in the caudal spinal cord, radicular involvement with granulomatous changes surrounding the conus medullaris and nerve roots of the cauda equina, necrotic exudative granulomas and haemorrhage, and asymptomatic deposition of ova in the spinal cord 46,54 .…”

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 .…”

Section: Clinical Syndromesmentioning

confidence: 99%

“…The granulomatous form is the most frequent one and the concomitance between the granulomatous and radicular forms is very common 56 . The clinical picture of spinal NS may be occasionally less suggestive of the entity, mainly when higher segments of the spinal cord are involved or when there is a slower progression of the neurological signs and symptoms 16 .…”

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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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: Clinical Syndromesmentioning

confidence: 99%

Section: Clinical Syndromesmentioning

confidence: 99%

See 2 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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“…The neuroschistosomiasis (NS) refers to the involvement of the central nervous system (CNS), symptomatic or asymptomatic. When symptomatic, NS is one of the most severe presentations of schistosomal infection [4] . The pathogenesis of CNS lesions produced by schistosomes depends on both the presence of the parasite eggs in the nervous tissue and the host immune response [5] .…”

Section: Introductionmentioning

confidence: 99%

Research development of the pathogenesis pathways for neuroschistosomiasis

Wang

Chen

et al. 2010

Neurosci. Bull.

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Abstract:The infection of the central nervous system (CNS) by schistosome may or may not have clinical manifestations.When symptomatic, neuroschistosomiasis (NS) is one of the most severe presentations of schistosome infection. Among the NS symptoms, cerebral invasion is mostly caused by Schistosoma japonicum (S. japonicum), and the spinal cord symptoms are mainly caused by S. mansoni or S. haematobium. There are 2 main pathways by which schistosomes cause NS: egg embolism and worm migration, via either artery or vein system, especially the valveless perivertebral Batson's plexus. The adult worm migrates anomalously through the above pathways to the CNS where they lay eggs. Due to the differences in species of schistosomes and stages of infection, mechanisms vary greatly. The portal hypertension with hepatosplenic schistosomiasis also plays an important role in the pathogenesis. Here the pathways through which NS occurs in the CNS were reviewed.

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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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Involvement of central nervous system in the schistosomiasis

Abstract: The involvement of the central nervous system (CNS)

Cited by 84 publications

References 15 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

Research development of the pathogenesis pathways for neuroschistosomiasis

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

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