Myeloradiculopathy associated to Schistosoma mansoni.
Neuroschistosomiasis caused by Schistosoma mansoni (Sm) is a rare and severe condition potentially leading to permanent neurological deficit. An 18-year-old Brazilian female was admitted due to a severe conus medullaris and cauda equina syndrome. MRI of thoracic/lumbar spine showed an expanded conus medullaris with patchy gadolinium-enhancement, needle electromyography revealed acute bilateral radiculopathy (L5-S1-S2), cerebrospinal fluid (CSF) showed lymphocytosis and increased proteins and lesion' surgical biopsy documented a lymphocyte infiltrate. Immunodiagnosis with cercariae hullen reaction using Sm cercariae in CSF and serum and immunoelectrodiffusion for circulating antigens detection using anti-Sm antibodies were positive. No schistosoma parasites were found. The patient was treated with praziquantel and corticotherapy for 6 months. At 1 month, partial clinical improvement was noticed, and MRI showed a normal size conus medullaris. At 6 months, there was complete clinical recovery. This case shows that a severe neurological deficit by Sm may have a clinical full recovery after treatment.
Neurology Department, Hospital de Santa Maria, Lisbon, Portugal. anapa.pitalobo@gmail.com
Patrícia Pita
PP
Lobo
Miguel
M
Coelho
Ruth
R
Geraldes
Carolina
C
Santos
Maria
M
Grácio
Mário Miguel
MM
Rosa
João Lobo
JL
Antunes
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D020818:Neuroschistosomiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D011128:Polyradiculopathy / Q000209:etiology / Q000469:parasitology; D011223:Praziquantel / Q000627:therapeutic use; D012550:Schistosoma mansoni; D012555:Schistosomiasis mansoni / Q000150:complications* / Q000188:drug therapy; D013117:Spinal Cord Compression / Q000209:etiology / Q000469:parasitology
D000305:Adrenal Cortex Hormones; D000871:Anthelmintics; D011223:Praziquantel