Hemidystonia secondary to acquired toxoplasmosis in a non-immunodeficient patient

Micheli, Roberto; Duse, Marzia

doi:10.1007/bf01954489

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…To our knowledge, only 3 cases of Toxoplasma gondii associated facial nerve palsy in immunocompetent children have been reported in the literature by now, dating back many decades. [12][13][14] A common characteristic in these case reports, as well as in other described cases with neurological involvement following Toxoplasma gondii infection, [4][5][6][7][8][9][10][11] is the intact immune system. Immunologic investigation in our patient also failed to reveal an underlying deficiency state.…”

Section: Discussionmentioning

confidence: 99%

“…2 Neurological complications in immunocompetent children following Toxoplasma gondii infection are very rare 3 and few cases have been previously reported. [4][5][6][7][8][9][10][11] Acute facial nerve palsy is even more rare. [12][13][14] Herein, we report the case of a young boy who presented with cervical lymphadenopathy because of acquired toxoplasmosis accompanied with acute unilateral facial nerve paralysis.…”

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confidence: 99%

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Acquired Toxoplasmosis Accompanied by Facial Nerve Palsy in an Immunocompetent 5-Year-Old Child

et al. 2010

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Acquired toxoplasmosis, although relatively common in children, is usually asymptomatic but can also be clinically manifested by a benign and self-limited infectious mononucleosis-like syndrome. Neurological complications are very rare in immunocompetent children. The authors report a 5-year-old boy who presented with cervical lymphadenopathy because of acquired toxoplasmosis accompanied with unilateral facial nerve paralysis. Toxoplasma gondii DNA detection in blood by polymerase chain reaction, as well as elevated specific immunoglobulin M antibodies against it, established the diagnosis. Characteristic brain lesions on magnetic resonance imaging were absent and ophthalmologic examination revealed no inflammatory lesions in the retina and choroid. Treatment with pyrimethamine, sulfadiazine, and folic acid resulted in a complete recovery after 2 months of therapy. Although rare, acute facial nerve paralysis of unknown origin can be caused by acquired toxoplasmosis even in the immunocompetent pediatric population. Elevated titers of specific antibodies and the presence of parasite's DNA are key findings for the correct diagnosis.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Acquired Toxoplasmosis Accompanied by Facial Nerve Palsy in an Immunocompetent 5-Year-Old Child

et al. 2010

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“…Cerebral toxoplasmosis abscesses, mostly affecting immunocompromised patients, usually localize to the basal ganglia, thalami and midbrain [ 96 ] and may cause chorea and dystonia [ 16 , 116 ], although it is extremely rare in children. Similarly, cryptococcal abscess are a potential alternative cause [ 16 ].…”

Section: Infectious and Para-infectious Disordersmentioning

confidence: 99%

Acute Movement Disorders in Childhood

Garone

Graziola

Grasso

et al. 2021

JCM

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Acute-onset movement disorders (MDs) are an increasingly recognized neurological emergency in both adults and children. The spectrum of possible causes is wide, and diagnostic work-up is challenging. In their acute presentation, MDs may represent the prominent symptom or an important diagnostic clue in a broader constellation of neurological and extraneurological signs. The diagnostic approach relies on the definition of the overall clinical syndrome and on the recognition of the prominent MD phenomenology. The recognition of the underlying disorder is crucial since many causes are treatable. In this review, we summarize common and uncommon causes of acute-onset movement disorders, focusing on clinical presentation and appropriate diagnostic investigations. Both acquired (immune-mediated, infectious, vascular, toxic, metabolic) and genetic disorders causing acute MDs are reviewed, in order to provide a useful clinician’s guide to this expanding field of pediatric neurology.

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“…A forma neurológica em pacientes imunocompetentes inclui casos de meningoencefalite, meningite, polirradiculoneurite, hemidistonia, tetraparesia e paralisia do nervo facial 16,21,22 . Nos casos de meningoencefalite, as principais manifestações clínicas são cefaléia, distúrbio de comportamento e do nível de consciência, sendo de maior preocupação a diminuição da acuidade auditiva que, quando ocorre, pode permanecer como seqüela do quadro agudo 23 .…”

Section: Quadro Clínicounclassified

Acquired toxoplasmosis

Carvalho¹,

Farhat²

1999

J Pediatr (Rio J)

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ResumoObjetivo: O objetivo desta revisão é apresentar de forma prática alguns aspectos importantes da toxoplasmose adquirida na prática clínica do pediatra.Métodos: Foram revistos todos os artigos publicados nos últimos dez anos e indexados no Index Medicus nessa última década, cujo assunto era toxoplasmose adquirida. De cada artigo foram selecionados, de modo crítico, aspectos de interesse para a prática pediátrica.Resultados: Descrevemos no artigo aspectos de epidemiologia, fisiopatologia, quadro clínico, diagnóstico, tratamento e prevenção da toxoplasmose adquirida.Conclusão: O conhecimento dos aspectos descritos neste artigo facilita o manejo de casos clínicos que possam ter entre as suspeitas diagnósticas a toxoplasmose adquirida. AbstractObjective: The aim of this review is to present some important aspects of acquired toxoplasmosis to the pediatric practitioner.Method: All the articles about acquired toxoplasmosis published during the last decade and indexed in the Index Medicus were revised. From each one, interesting aspects were critically selected.Results: We describe aspects of the epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment and prevention related to acquired toxoplasmosis.Conclusion: The content of this article may facilitate the management of patients suspected of having acquired toxoplasmosis. IntroduçãoToxoplasmose é uma zoonose descrita em todo o mundo, causada pelo Toxoplasma gondii, que é um protozoário, parasita intracelular, responsável por infecção em seres humanos e em alguns animais herbívoros, carnívoros e onívoros. O gato é o hospedeiro definitivo. Na espécie humana, a toxoplasmose adquirida na vida pós-natal, também chamada simplesmente de toxoplasmose adquirida 1 , apresenta um curso benigno, até mesmo assintomático, na grande maioria dos hospedeiros imunocompetentes. No entanto, a evolução latente ou crônica dessa infecção, devido à persistência do T. gondii na forma de cisto, pode apresentar reativação no curso de imunossupressão.O T. gondii apresenta-se em várias formas na natureza: o oocisto é o resultado do ciclo sexual que ocorre no intestino delgado dos gatos e contém os esporozoitos; o taquizoito é a forma assexuada invasiva; e o cisto contém os bradizoitos capazes de persistir nos tecidos durante a fase latente da infecção. O oocisto é excretado junto com as fezes dos gatos e pode persistir viável por até 18 meses em solo úmido, representando uma fonte potencial de infecção; requer a esporulação para ter poder infectante. Esta ocorre em 2 a 3 dias em temperatura ambiental de 24 o C, ou em 14 a 21 dias em temperatura ambiental de 11 o C e não ocorre em temperaturas acima de 37 o C ou abaixo de 4 o C. O taquizoito é visto na fase aguda da infecção e pode invadir todas as células dos mamíferos, que se tornam hospedeiros intermediários por acometimento intracelular obrigatório. Quando ocorre lise da célula por excesso de taquizoitos, estes são destruídos pelo sistema imune do hospedeiro através da resposta humoral ativada pelo sistema complemento. ...

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Hemidystonia secondary to acquired toxoplasmosis in a non-immunodeficient patient

Cited by 6 publications

References 8 publications

Acquired Toxoplasmosis Accompanied by Facial Nerve Palsy in an Immunocompetent 5-Year-Old Child

Acquired Toxoplasmosis Accompanied by Facial Nerve Palsy in an Immunocompetent 5-Year-Old Child

Acute Movement Disorders in Childhood

Acquired toxoplasmosis

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