Cerebral paragonimiasis: a retrospective analysis of 89 cases.
OBJECTIVE
We reviewed the clinical and follow-up data of 89 cases with cerebral paragonimiasis and summarized the disease characteristics, diagnostic strategies and treatment experience, with an expectation of establishing standard diagnosis and treatment for cerebral paragonimiasis.


METHODS
A total of 89 cases (age: 2-64 years) of cerebral paragonimiasis admitted and treated in our hospital in the past 10 years were included in this study. The clinical symptoms were manifested by headache, epilepsy, paralysis, etc. In order to confirm the diagnosis, we performed imaging examinations (e.g., CT and MRI) and laboratory tests (ELISA and eosinophil counting). Seventy-two patients received oral administration of praziquantel only, 16 cases received surgical resection of the lesions and 33 cases received appropriate anti-epileptic therapies. The diagnostic, treatment and follow-up data were statistically analyzed.


RESULTS
Follow-up was performed for 73 cases for a period of 6-48 months and the original symptoms were markedly improved without recurrence. 15 patients were lost to follow-up after discharge. One patient died of epilepticus insult, high fever and convulsions. Although 4 patients still had seizures within 6 months of treatment, seizure frequency was significantly reduced. Histopathological evaluation demonstrated inflammatory changes with esoinophilic infiltration in all 16 patients who underwent surgical resection.


CONCLUSIONS
Young patients (age: <18 years) are more likely to have cerebral hemorrhage. SWI imaging contributes to the diagnosis of hemorrhagic lesions. Cerebral paragonimiasis can cause epilepsy, especially grand mal seizures.
Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing, 400038 People's Republic of China.
Jingyu
J
Chen
Zhi
Z
Chen
Jiangkai
J
Lin
Gang
G
Zhu
Hui
H
Meng
Gaoyu
G
Cui
Nan
N
Wu
Rong
R
Hu
Jiexiang
J
Pan
Yongjie
Y
Zou
Hua
H
Feng
D000293:Adolescent; D000328:Adult; D000980:Antiplatyhelmintic Agents / Q000627:therapeutic use; D001921:Brain / Q000469:parasitology / Q000473:pathology; D001927:Brain Diseases / Q000175:diagnosis / Q000469:parasitology / Q000628:therapy*; D001929:Brain Edema / Q000209:etiology / Q000473:pathology; D002533:Cerebral Angiography; D002648:Child; D002675:Child, Preschool; D002681:China; D004797:Enzyme-Linked Immunosorbent Assay; D004804:Eosinophils; D004827:Epilepsy / Q000209:etiology; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology; D007958:Leukocyte Count; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010237:Paragonimiasis / Q000175:diagnosis / Q000469:parasitology / Q000628:therapy*; D011223:Praziquantel / Q000627:therapeutic use; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
D000980:Antiplatyhelmintic Agents; D011223:Praziquantel