Multifocal Central Nervous System Lesions in Three Patients With Trichinosis

Ellrodt, A.; Halfon, Patricia; Bras, P. Le; Halimi, P.; Bourée, Patrice; Desi, M; Caquet, René

doi:10.1001/archneur.1987.00520160064016

Cited by 52 publications

(17 citation statements)

References 10 publications

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“…These arguments are not irrefutable because eosinophilic meningitis or meningoencephalitis may be idiopathic or produced by larvae of such human helminths (reviewed in reference 19) as Ascaris lumbricoides or Strongyloides stercoralis 24 25 , Ascaris suum 16 18 23 32 , Trichinella spiralis 10 or by larvae of other paratenic nematodes such as the rat nematode Angiostrongylus cantonensis 33 42 and raccoon ascarid, Baylisascaris procyonis 34 . Since Ascaris antigens can cross react with Toxocara antigens, one could argue that the positive serology observed in the two cases reported here may be due to this cross reaction.…”

Section: Discussionmentioning

confidence: 99%

Toxocariasis of the central nervous system: with report of two cases

Moreira-Silva

Rodrigues

Pimenta

et al. 2004

Rev. Soc. Bras. Med. Trop.

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Section: Discussionmentioning

confidence: 99%

Toxocariasis of the central nervous system: with report of two cases

Moreira-Silva

Rodrigues

Pimenta

et al. 2004

Rev. Soc. Bras. Med. Trop.

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“…4 Vascular changes, primarily microinfarctions, are thought to be most responsible for neurologic injury and may be mediated by the hypereosinophilic state. 5,6 In previous reports, CT imaging of the brain revealed multifocal hypodensities in the cerebral cortex and white matter. 5,6 The MRI appearance of neurotrichinosis is less frequently described in the literature.…”

Section: Oy-stersmentioning

confidence: 95%

“…5,6 In previous reports, CT imaging of the brain revealed multifocal hypodensities in the cerebral cortex and white matter. 5,6 The MRI appearance of neurotrichinosis is less frequently described in the literature. Lesions appear hyperintense on T2-weighted images, enhance with gadolinium, and show restricted diffusion on diffusion-weighted imaging.…”

Section: Oy-stersmentioning

confidence: 95%

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Pearls & Oy-sters: A rare case of neurotrichinosis with MRI

2014

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Pearls & Oy-sters: A rare case of neurotrichinosis with MRI PEARLS 1. The neurologic manifestations of trichinosis are diverse and range from encephalopathy to cerebral, cerebellar, and spinal cord abnormalities. 2. MRI lesions enhance with contrast and are postulated to represent small areas of infarction. 3. Imaging typically normalizes within 1 to 2 months after infection. OY-STERS1. Neurotrichinosis should be considered in patients with marked eosinophilia and unexplained neurologic symptoms. 2. Outcomes may be improved with the administration of steroids and anthelmintic agents during the enteral phase of infection.CASE REPORT A 41-year-old left-handed man from a northern Canadian district presented to a community hospital with a 3-week history of watery diarrhea, a self-resolved erythematous pruritic rash, fever, confusion, and facial swelling. A CT scan of the head showed areas of decreased attenuation bilaterally in the periventricular regions of the frontal lobes. He was offered admission for workup but declined and was sent home with antibiotics. He returned to the hospital 3 days later with new complaints of left face numbness as well as left arm numbness, weakness, and clumsiness. His partner noted that he was sleeping more than usual and had word-finding difficulties. Other symptoms included daily bifrontal headache, "red spots" briefly appearing in his visual field, and ataxia. Medical history was significant for vasectomy, 20-pack-year smoking history, and headaches. He had no allergies and no regular medications.On admission, vital signs were within normal limits, and there was no documented fever. Cardiorespiratory and abdominal examination results were normal. There was no facial edema or skin lesions. Cognition was intact. He had a normal cranial nerve and sensory examination. Strength in the left upper extremity was decreased to 4/5 in all muscle groups. The remainder of the strength examination was normal. Reflexes were present and symmetric. There was a left-sided pronator drift, slowing of finger-to-nose testing, and inability to perform rapid alternating movements with the left arm. Gait was unstable, and the patient used a wheelchair to mobilize in the hospital.Laboratory tests were remarkable for a leukocyte count of 15.3 3 10 9 /L, an eosinophil count of 5.8 3 10 9 /L (38%), platelets of 147 3 10 9 /L, creatine kinase of 290 U/L, troponin of 3.12 mg/L, and erythrocyte sedimentation rate of 34 mm/h. There was no evidence of ST elevation on ECG, and chest x-ray was normal. CSF analysis showed glucose of 57.6 mg/dL, protein 34 mg/dL, erythrocytes 9.5/mm 3 , leukocytes 3.6/mm 3 , and a negative Gram stain and culture. There were too few leukocytes in the CSF to provide a differential. Blood cultures, stool culture, and stool for ova and parasites were all negative. Rheumatologic markers were negative. Echocardiogram showed normal ventricular and valvular function. An EEG showed slow-wave activity in the left temporal region. There was no epileptiform activity.Brain MRI (figure) demonstrate...

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“…Apart from Trichinella spiralis other parasitic infections that may cause abnormal mental status and eosinophilia include toxocariasis (Despommier, 2003), angiostrongyloidiasis, and baylisascariasis (Gavin et al, 2005). Clinical signs and symptoms are meningitis, encephalitis, cranial nerve deficits, paresis, aphasia, convulsions and coma (Fourestie et al, 1993;Gay et al, 1982) Small hypodense areas in the white matter and in the cortex have been reported long time ago (Ellrodt et al, 1987). Absence of pets at home or contact with raccoons, the lack of eosinophils in the CSF, and the lack of ocular larva migrans on examination argue against trichinellosis.…”

Section: Neurotrichinellosis Trichinellosis Also Called Trichinosis mentioning

confidence: 99%

Epilepsy Secondary to Parasitic Zoonoses of the Brain

Foyaca-Sibat¹

2011

Novel Aspects on Epilepsy

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Multifocal Central Nervous System Lesions in Three Patients With Trichinosis

Cited by 52 publications

References 10 publications

Toxocariasis of the central nervous system: with report of two cases

Toxocariasis of the central nervous system: with report of two cases

Pearls & Oy-sters: A rare case of neurotrichinosis with MRI

Epilepsy Secondary to Parasitic Zoonoses of the Brain

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