[Schistosomal myeloradiculopathy].
Schistosomal myeloradiculopathy is the most severe and disabling ectopic form of schistosomiasis mansoni. Its prevalence in endemic areas has been underestimated. The diagnosis relies on the presence of low thoracic/upper lumbar neurological symptoms, demonstration of the Schistosoma mansoni infection by microscopic or serologic techniques, and exclusion of other causes of transverse myelitis. When treatment with antischistosomal drugs and corticosteroids is started early, the clinical response is surprisingly good and those left untreated do not improve and frequently die. There is no consensus about doses and duration of treatment, but a recent study suggests that when steroids are given for at least 6 months clinical improvement is enhanced. As the diagnosis of SMR is presumptive and treatment is essentially clinical, physicians should be aware of the disease and more research is needed to increase the accuracy of the diagnostic methods and, hence, to avoid routine laminectomy. With the advent of magnetic resonance imaging of the spinal cord the diagnosis of this ectopic form of the disease was facilitated. In accordance, the number of cases of schistosomal myelopathy reported is increasing rapidly.
Serviço de Doenças Infecciosas e Parasitárias da Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Luciana Cristina dos Santos
LC
Silva
Pedro Ernane
PE
Maciel
João Gabriel Ramos
JG
Ribas
Sílvio Roberto de Sousa
SR
Pereira
José Carlos
JC
Serufo
Luciene Mota
LM
Andrade
Carlos Maurício
CM
Antunes
José Roberto
JR
Lambertucci
D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D002648:Child; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D020818:Neuroschistosomiasis / Q000175:diagnosis* / Q000188:drug therapy; D011223:Praziquantel / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use
D000871:Anthelmintics; D005938:Glucocorticoids; D011223:Praziquantel; D007559:Ivermectin; D011239:Prednisolone