Neurological manifestations of gnathostomiasis.
Neurological features of 24 patients with nervous system gnathostomiasis were reviewed. The commonest presenting features were radiculomyelitis or radiculomyelitis terminating with encephalitis, and subarachnoid haemorrhage. A primary encephalitic form was noted in 2 patients. The salient feature of the disease was a sudden onset of extremely severe radicular pain and/or headache followed by paralysis of the extremities and/or the cranial nerves. Migration signs were also the hallmark of nervous system gnathostomiasis. No single area of the nervous system was inaccessible to the highly invasive gnathostome lava. Multiplicity and/or rapid progress of lesions beyond the degree of cerebral oedema could only be explained by further migration of the parasite. Death occurred in 6 patients from direct extensive involvement of vital centres in the brain stem or from complications such as pneumonia or septicaemia. Multiple cranial nerve palsies were usually bad prognostic signs.
D000293:Adolescent; D000328:Adult; D001933:Brain Stem / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000166:cytology; D004660:Encephalitis / Q000209:etiology / Q000473:pathology; D004804:Eosinophils; D005260:Female; D006039:Gnathostoma; D006261:Headache / Q000209:etiology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009187:Myelitis / Q000209:etiology / Q000473:pathology; D009349:Nematode Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications*; D009461:Neurologic Manifestations; D011843:Radiculopathy / Q000209:etiology; D013116:Spinal Cord / Q000473:pathology; D013151:Spiruroidea