title: Neurotoxocariasis: a systematic literature review.
abstract: OBJECTIVE
  Toxocariasis is a widespread zoonosis, which may result in central nervous system injury.
  
  
  METHODS
  We conducted a systematic literature review in MEDLINE, SciELO, ScienceDirect and Google Scholar up to April 2015 using a combination of the following search terms: "neurotoxocariasis" or "neurotoxocarosis", "toxocariasis" or "toxocarosis" and "cerebral" or "neurologic".
  
  
  RESULTS
  One hundred cases of neurotoxocariasis were identified in literature. The majority of patients were male (58 %), with a median age of 42 years. The predominant clinical pictures were myelitis (60 %), encephalitis (47 %) and/or meningitis (29 %). Fever was inconstant (23 %). The suspected mode of transmission, mentioned in only 49 % of cases, was mainly contact with dogs and/or cats (67 %) and ingestion of contaminated food (31 %). Diagnostic imaging examinations found hypodense lesions in cerebral scanner sequences and hyperintense lesions in cerebral MRI T2-weighted sequences in 65 and 57 % of encephalitis cases respectively, and in 92 % of myelitis cases in medullary MRI T2-weighted sequences. The detection of antibodies against Toxocara spp. was almost constant in blood and cerebrospinal fluid (CSF), 99 and 93 %, respectively. The two most commonly used drugs were corticosteroids (72 %) and/or albendazole (68 %) for a period of at least 3 weeks, which often needed to be repeated. Despite a low mortality rate (6 %), complete remission was observed in only 40 % of cases.
  
  
  CONCLUSIONS
  Neurotoxocariasis, a completely preventable zoonosis, could lead to severe sequelae failing prompt diagnosis. A compatible clinical picture, presence of risk factors, blood eosinophilia and high titers of antibodies against Toxocara spp. in CSF should alert physicians.
authors.affiliation: Department of Internal Medicine, CHU de Caen, Caen, 14000, France.
authors.forename: S
authors.initials: S
authors.lastname: Deshayes
authors.affiliation: Department of Microbiology, CHU de Caen, Caen, 14000, France.
authors.forename: J
authors.initials: J
authors.lastname: Bonhomme
authors.affiliation: Department of Infectious Diseases, CHU de Caen, Caen, 14000, France. delablanchardiere-a@chu-caen.fr.
authors.forename: Arnaud
authors.initials: A
authors.lastname: de La Blanchardière
mesh_terms: D000871:Anthelmintics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology; D014120:Toxocariasis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology
chemical_list: D000871:Anthelmintics
keywords: Encephalitis; Myelitis; Neurotoxocariasis; Neurotoxocarosis