Schistosomiasis of the spinal cord

Ghaly, A. F.; El-Banhawy, Ahmed

doi:10.1002/path.1711110110

Cited by 30 publications

(8 citation statements)

References 10 publications

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“…'2,43 On gross inspection, the lesion appears as an intramedullary yellowish, amorphous or rubbery granuloma with a tendency to extend along the nerve roots in the cauda equina. 43 The radiologic and histologic appearances of spinal schistosomal granulomas are characteristic, as described later.…”

Section: Granulomatous Mass Lesions Of the Conus Medullarzs And Caudamentioning

confidence: 86%

Spinal and Cerebral Schistosomiasis

Liu¹

1993

Semin Neurol

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Section: Granulomatous Mass Lesions Of the Conus Medullarzs And Caudamentioning

confidence: 86%

Spinal and Cerebral Schistosomiasis

Liu¹

1993

Semin Neurol

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“…The first case of SCS in Egypt was reported in 1968. [45] The assumed mechanism that explains predilection of lesions to lower spinal cord in current study is the existence of valve-free venous plexus (Batson system) that anatomizes the intraabdominal and spinal veins. This shunt becomes more active and patent in cases with increased intraabdominal pressure which permits the S. mansoni eggs to migrate through these plexus to the spinal cord.…”

Section: Discussionmentioning

confidence: 93%

“…Afterward, a few cases with bilharzial spinal cord lesions from Egypt, South Africa, and Brazil were reported. [5]…”

Section: Introductionmentioning

confidence: 99%

Schistosomal myeloradiculopathy due to Schistosoma mansoni: Report on 17 cases from an endemic area

Badr

Shaker

Mansour

et al. 2011

Ann Indian Acad Neurol

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Background:After malaria, schistosomiasis is the second most prevalent tropical disease. The prevalence of oviposition in CNS of infected persons varies from 0.3 to 30%. The conus medullaris is a primary site of schistosomiasis, either granulomatous or acute necrotizing myelitis.Objective:To report the clinical, radiological, and laboratory results of spinal cord schistosomiasis (SCS) and to design proper therapeutic regimens.Materials and Methods:Seventeen patients (13 males and four females) with SCS were enrolled between 1994 and 2009 at Mansoura University Hospitals. Their median age at diagnosis was 19 years (13-30 years). Independent neurological, radiological, and laboratory assessments were performed for both groups, excluding pathological confirmation that was done earlier in eight patients (Group 1). In the group 2 (nine patients), indirect hemagglutination (IHA) test for bilharziasis in blood and cerebrospinal fluid (CSF) was performed. Higher positive titer in CSF than serum indicated SCS plus induction of antibilharzial and corticosteroid protocols for 12 months with a three-year follow-up.Results:Rate of neurological symptoms of granulomatous intramedullary cord lesion was assessed independently in 16 cases and acute paraparesis in one case. All patients in group 2 had positive IHA against Schistosoma mansoni with median CSF and serum ranges 1/640 and 1/320, respectively. Seven patients (41.18%) had complete recovery, eight patients (47.06%) showed partial recovery, and no response was reported in two patients (11.76%) (P = 0.005). There was no recorded mortality in the current registry.Conclusions:Rapid diagnosis of SCS with early medical therapies for 12 months is a crucial tool to complete recovery.

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“…20 A unique clinical picture seen in this disease, in which young patient present with lumbar pain, often of radicular nature , soon followed by rapid gradual progression of weakness of the lower limbs and associated with autonomic dysfunction. 4,5,8,20 Spinal cord schistosomiasis due to S Mansoni may present as myelopathy, radiculopathy or both and rarely as a syndrome of anterior spinal artery occlusion. Until the clinical presentation with spinal cord symptoms, most patients have neither suggestive history nor a clinical sign of hepatosplenic schistosomiasis.…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Schistosomiasis: Diagnosis, Pathological Features and Treatment.

Abdeen

El-Sawy

Abdelzaher

2014

Egyptian Spine Journal

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Background Data: Schistosomiasis affects over 200 million people worldwide. Involvement of the CNS is a rare occurrence. Spinal cord involvement is a rare manifestation of schistosomiasis, the conus medullaris being the primary site of spinal involvement. Purpose: We describe the clinical presentation and the MRI findings of spinal cord schistosomiasis in correlation with surgery and histopatholgical findings. Study Design: Clinical case study. Patients and Methods: We report four cases of spinal cord schistosomiasis presented with rapidly progressive paraparesis associated with urinary incontinence. Three patients were males and one was female (mean age 16 years). MRI of the spine demonstrated a diffusely enhancing mass at the conus medullaris with spinal cord edema, in one of the cases, the edema extended to the upper thoracic segment. Results: In all cases, spinal masses were surgically managed through decompressive laminectomy and either biopsy or debulking. Histopathological examination showed a granulomatous inflammation surrounding bilharzial ova with a final diagnosis of spinal cord schistosomiasis. Patients were treated with Praziquantel and oral steroids. They made a remarkable neurological recovery. Conclusions: Spinal cord schistosomiasis inspite its rare occurrence, must be considered in the differential diagnosis of conus medullaris lesions. Accurate diagnosis, through recognition of its MRI appearance, allows early treatment. Better prognosis depends on decompressive laminectomy, oral steroids to abort intense immune reaction surrounding the ova and antibilharzial drug. (2014ESJ055)

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Schistosomiasis of the spinal cord

Cited by 30 publications

References 10 publications

Spinal and Cerebral Schistosomiasis

Spinal and Cerebral Schistosomiasis

Schistosomal myeloradiculopathy due to Schistosoma mansoni: Report on 17 cases from an endemic area

Spinal Cord Schistosomiasis: Diagnosis, Pathological Features and Treatment.

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