title: Spinal Cord Lesions in Congenital Toxoplasmosis Demonstrated with Neuroimaging, Including Their Successful Treatment in an Adult.
abstract: Neuroimaging studies for persons in the National Collaborative Chicago-Based Congenital Toxoplasmosis Study (NCCCTS) with symptoms and signs referable to the spinal cord were reviewed. Three infants had symptomatic spinal cord lesions, another infant a Chiari malformation, and another infant a symptomatic peri-spinal cord lipoma. One patient had an unusual history of prolonged spinal cord symptoms presenting in middle age. Neuroimaging was used to establish her diagnosis and response to treatment. This 43 year-old woman with congenital toxoplasmosis developed progressive leg spasticity, weakness, numbness, difficulty walking, and decreased visual acuity and color vision without documented re-activation of her chorioretinal disease. At 52 years of age, spinal cord lesions in locations correlating with her symptoms and optic atrophy were diagnosed with 3 Tesla MRI scan. Treatment with pyrimethamine and sulfadiazine decreased her neurologic symptoms, improved her neurologic examination, and resolved her enhancing spinal cord lesions seen on MRI.
authors.affiliation: Department of Radiology, The University of Chicago, Chicago, IL.
authors.forename: Delilah
authors.initials: D
authors.lastname: Burrowes
authors.forename: Kenneth
authors.initials: K
authors.lastname: Boyer
authors.forename: Charles N
authors.initials: CN
authors.lastname: Swisher
authors.forename: A Gwendolyn
authors.initials: AG
authors.lastname: Noble
authors.forename: Mari
authors.initials: M
authors.lastname: Sautter
authors.forename: Peter
authors.initials: P
authors.lastname: Heydemann
authors.forename: Peter
authors.initials: P
authors.lastname: Rabiah
authors.forename: Daniel
authors.initials: D
authors.lastname: Lee
authors.forename: Rima
authors.initials: R
authors.lastname: McLeod
keywords: 3 Tesla MRI with contrast; NCCCTS; congenital toxoplasmosis; myelitis and optic neuritis; spasticity; treatment with resolution of signs and symptoms