ABSTRACT. A longitudinal study of nematode infection in chimpanzees was conducted between 1989 and 1994 on the M group chimpanzees of the Mahale Mountains National Park, Tanzania during two annual dry and rainy season periods and a third rainy season. Chemical and physical antiparasite properties of medicinal plant use against the strongyle nematode Oesophagostomum stephanostomum have recently been reported at Mahale. Here, the incidence of nematode infections were analyzed for seasonal trends to elucidate the possible influence of parasite infection on previously reported seasonality of medicinal plant use and to test the hypothesis that the use of these plants is stimulated by O. stephanostomum. The number of chimpanzees infected by O. stephanostornum was significantly higher in the rainy season than in the dry season of both 1989-1990 and 1991-1992. However, the incidence of Trichuris trichiura and Strongyloides fuelleborni showed no seasonality. Reinfection of individuals by O. stephanostomum occurred in synchrony with annual variation in rainfall: there was a sharp rise in the occurrence of new infections per individual within one to two months after the beginning of the first heavy rains of the season. This pattern coincides with the reproductive cycle of this nematode species. O. stephanostomum (95~ infections were associated significantly more frequently with medicinal plant use than either T. trichiura (50~ or S. fuelleborni (40~ infections. These observations are consistent with previous reports for the increased use of these plants during the rainy season and are consistent the hypothesis that medicinal plant use is stimulated by O. stephanostomum infection.

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Context: Acute hemiparesis is a common initial presentation of ischemic stroke. Although hemiparesis due to spontaneous spinal epidural hematoma (SSEH) is an uncommon symptom, a few cases have been reported and misdiagnosed as cerebral infarction. Design: Case reports of SSEH with acute hemiparesis. Findings: In these two cases, acute stroke was suspected initially and administration of intravenous alteplase therapy was considered. In one case, the presentation was neck pain and in the other case, it was Lhermitte's sign; brain magnetic resonance imaging (MRI) and magnetic resonance angiography were negative for signs of ischemic infarction, hemorrhage, or arterial dissection. Cervical MRI was performed and demonstrated SSEH. Conclusion: Clinicians who perform intravenous thrombolytic treatment with alteplase need to be aware of this possible contraindication.

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