Pseudotumoral form of neuroschistosomiasis: report of three cases.
Central nervous system (CSN) involvement in schistosomiasis is an ectopic manifestation with a large variety of clinical forms, including pseudotumoral, which occurs in isolated cases and is rare. Three patients with epidemiological indications of this pathology were examined; the clinical picture included lower-back pain irradiating to lower limbs, associated with progressive flaccid paraparesis and sphincterial disturbances in cases in which the spinal chord was involved; while in cases with encephalitic impairment, headache, dizziness and cerebellar syndrome, characterized by dysarthria and right-side dysgraphia, were present. Magnetic resonance imaging (MRI) showed a growing process in all cases; cerebrospinal fluid (CSF) characteristics and biological markers were compatible with neuroschistosomiasis (NS). Biopsy of the lesions confirmed this diagnosis in one case. After specific treatment with schistosomicides and corticosteroids, clinical, radiological and laboratorial improvement was observed.
Andrade Filho
Antonio S
AS
Service of Clinical Neurology, HUPES-UFBA, Brazil. andradeneuro@uol.com.br
Queiroz
Aristidez C
AC
Freire
Antonio C C
AC
Lima
Leonardo Conrado S
LC
Filho
Celso A S
CA
Amado
Isolda N
IN
Reis
Mittermeyer G
MG
Magalhães
Isis Fernandes
IF
Carmo
Theomira M A
TM
D000293:Adolescent; D000328:Adult; D000871:Anthelmintics / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020818:Neuroschistosomiasis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy; D011223:Praziquantel / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000871:Anthelmintics; D005938:Glucocorticoids; D011223:Praziquantel; D003907:Dexamethasone; D011241:Prednisone