Spinal cord involvement with Schistosoma mansoni

Herskowitz, Allan

doi:10.3171/jns.1972.36.4.0494

Cited by 27 publications

(6 citation statements)

References 12 publications

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“…12 In our study, the spinal abnormalities were located in the conus medullaris and the lower thoracic cord .This very consistent localization in the lower cord and conus region is explained by the free anastomosis between pelvic veins and the valveless vertebral veins, as well as between the hemorrhoidal and systemic veins. 5,10 Our data show the good sensitivity of MRI examination of the spinal cord in SMR, previously suggested by retrospective studies. MRI of the spinal cord was important in the diagnosis of SMR, allowing identification of images compatible with infectious myelitis (described previously as spinal cord enlargement, high signal intensity in T2weighted images, and diffuse nodular enhancement after contrast administration).…”

Section: Discussionsupporting

confidence: 77%

Spinal Cord Schistosomiasis: Diagnosis, Pathological Features and Treatment.

Abdeen

El-Sawy

Abdelzaher

2014

Egyptian Spine Journal

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Background Data: Schistosomiasis affects over 200 million people worldwide. Involvement of the CNS is a rare occurrence. Spinal cord involvement is a rare manifestation of schistosomiasis, the conus medullaris being the primary site of spinal involvement. Purpose: We describe the clinical presentation and the MRI findings of spinal cord schistosomiasis in correlation with surgery and histopatholgical findings. Study Design: Clinical case study. Patients and Methods: We report four cases of spinal cord schistosomiasis presented with rapidly progressive paraparesis associated with urinary incontinence. Three patients were males and one was female (mean age 16 years). MRI of the spine demonstrated a diffusely enhancing mass at the conus medullaris with spinal cord edema, in one of the cases, the edema extended to the upper thoracic segment. Results: In all cases, spinal masses were surgically managed through decompressive laminectomy and either biopsy or debulking. Histopathological examination showed a granulomatous inflammation surrounding bilharzial ova with a final diagnosis of spinal cord schistosomiasis. Patients were treated with Praziquantel and oral steroids. They made a remarkable neurological recovery. Conclusions: Spinal cord schistosomiasis inspite its rare occurrence, must be considered in the differential diagnosis of conus medullaris lesions. Accurate diagnosis, through recognition of its MRI appearance, allows early treatment. Better prognosis depends on decompressive laminectomy, oral steroids to abort intense immune reaction surrounding the ova and antibilharzial drug. (2014ESJ055)

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Section: Discussionsupporting

confidence: 77%

Spinal Cord Schistosomiasis: Diagnosis, Pathological Features and Treatment.

Abdeen

El-Sawy

Abdelzaher

2014

Egyptian Spine Journal

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“…Observação: O estudo do líquor, que deve ser realizado de rotina, pode apresentar alterações 18,20,24,26,27 que, para alguns autores, sugerem a etiologia esquistossomótica, tais como pleocitose linfomononuclear, aumento de proteína, eosinofilorraquia e, hipergamaglobulinorraquia 24 . Com relação à reatividade de reações imunológicas específicas para esquistossomose (imunofluorescência, ELISA, hemoaglutinação e/ou Western Blot), são poucos os estudos realizados, com casuística escassa, rescindindo-se, ainda, de padronização e normatização de valores normais e patológicos 14,17,24,28,29 .…”

Section: Diagnóstico Possívelunclassified

Perfil clínico e critérios diagnósticos da mielorradiculopatia esquistossomótica

Santos

Campos

Diniz

et al. 2001

Arq. Neuro-Psiquiatr.

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RESUMO -Durante período de 20 anos , 56 pacientes com diagnóstico de mielorradiculopatia esquistossomótica foram internados em três hospitais de Belo Horizonte Minas Gerais. Dados de cada paciente foram coletados retrospectivamente de seus prontuários. Em todos os casos, o diagnóstico foi presumido e baseou-se nos seguintes critérios: 1) quadro de comprometimento medular torácico baixo ou lombossacro (síndrome de cone medular e/ou cauda equina); 2) epidemiologia positiva para esquistossomose; 3) comprovação laboratorial de esquistossomose através de exame parasitológico de fezes ou biópsia retal; e 4) exclusão de outras patologias que pudessem causar quadro semelhante. Vários aspectos clínicos e epidemiológicos foram estudados para determinar o perfil diagnóstico da mielorradiculopatia esquistossomótica nesta amostra e são apresentados neste artigo. Reconhecendo os vários problemas no diagnóstico da mielorradiculopatia esquistossomótica, enfatizamos a importância de se pensar nesta entidade e sugerimos critérios para definição diagnóstica.PALAVRAS-CHAVE: esquistossomose mansoni, radiculopatia, mielite. Clinical profile and criteria for the diagnosis of schistosomotic myeloradiculopathyABSTRACT -During 20 year period 56 patients with a diagnosis of schistosomotic myeloradiculopathy were admitted in three hospitals of Belo Horizonte -Minas Gerais. Data from pacients were collected retrospectively from their medical records. In all cases, the diagnosis was inferred in a presumably way and was based on the following considerations: 1) the finding of low thoracic/upper lumbar neurological symptoms; 2) positive epidemiology for schistosomiasis; 3) demonstration of exposure to schistosomiasis through parasitologic or serologic techniques; and 4) the exclusion of other known causes of transverse myelitis and myeloradiculitis. Several clinical and epidemiological aspects were studied to determine the diagnosis profiles of the schistosomotic myeloradiculopathy in this sample and are presented in this paper. In recognizing the many problems in diagnosis of schistosomotic myeloradiculopathy we emphasize how important is thinking about this entity and criteria to improve diagnostic evaluation are suggested. O comprometimento do sistema nervoso no curso da esquistossomose mansoni vem ganhando, paulatinamente, importância cada vez maior na literatura especializada. As dificuldades no seu reconhecimento provavelmente limitam seu diagnóstico. Com relação ao sistema nervoso, não se conhece a frequência do seu envolvimento. Scrimgeour & Gajdusek (1981) relatam que, na Tanzânia, a esquistossomose foi responsável por 1% dos casos de paraplegia não traumática e que, em 5% de outros casos, estabeleceu-se o seu diagnóstico presuntivo 4 . A neuroesquistossomose pode resultar numa grande variedade de complicações. Seu diagnóstico é difí-

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“…Schistosoma may lead to granuloma like lesions in many parts of the central nervous system 2 . It has not well explained why in the central nervous system the S. mansoni is commonly ectopically located in the spinal cord, whereas the S. japonicum is preferably located in the brain 15 . The cerebral lesions have a worse prognosis leading to death 1 .…”

Section: T T T Tmentioning

confidence: 99%

Spinal cord schistosomiasis: Case report

Leitão¹,

Figueiredo²,

Figueiredo³

et al. 1999

Arq Bras Neurocir

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The authors present a case of spinal cord schistosomiasis which simulated a tumoral lesion determining spastic paraparesis with a sensitive-motor level at T1. The patient was treated with surgery, praziquantel and dexamethasone, with “restitutio ad integrum”. Seven years later the patient presented recrudescence of the symptoms, without a good response to the medication and without a plausible explanation.The authors wonder about the reasons of the low incidence of central nervous system schistosomosis in an endemic area such as the Northeast of Brazil. A brief review of the literature is done.

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Spinal cord involvement with Schistosoma mansoni

Cited by 27 publications

References 12 publications

Spinal Cord Schistosomiasis: Diagnosis, Pathological Features and Treatment.

Spinal Cord Schistosomiasis: Diagnosis, Pathological Features and Treatment.

Perfil clínico e critérios diagnósticos da mielorradiculopatia esquistossomótica

Spinal cord schistosomiasis: Case report

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