Jarupant Wasin, Sithinamsuwan Pasiri, Udommongkol Chesda, Reuarrom Kritti, Nidhinandana Samart, Suwantamee Jithanorm
Department of Medicine, Pramongkutklao Army Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2004 Oct;87(10):1244-9.
Neurocysticercosis is the most common parasitic infestation involving the central nervous system in tropical countries. Common presentations are seizure, meningitis and increased intracranial pressure. The authors report a case of a 52-year-old woman with racemose neurocysticercosis in the subarachnoid space at the cistern of the brain through the lumbar cistern. She presented with progressive paraparesis due to spinal cord compression and finally had progressive bilateral sensori-neural hearing loss. MRI brain and the whole spinal cord revealed numerous rim-enhancing cystic lesions at the basal cistern, prepontine cistern, bilateral cerebellopontine angle, internal acoustic canals, intramedullary lesion at the 5th cervical spinal level, lumbar cistern lesions and secondary syringomyelia at the thoracic spinal cord. The histopathologic examination confirmed cysticercosis. After treatment by albendazole and surgical removal, she still developed recurrent spinal compression at a higher level and obstructive hydrocephalus. Finally, she died from status epilepticus and septic shock.
神经囊尾蚴病是热带国家最常见的累及中枢神经系统的寄生虫感染。常见表现为癫痫发作、脑膜炎和颅内压升高。作者报告了一例52岁女性病例，其在脑池蛛网膜下腔通过腰大池发生葡萄状神经囊尾蚴病。她因脊髓受压出现进行性双下肢轻瘫，最终出现进行性双侧感音神经性听力丧失。脑部和全脊髓磁共振成像显示，在基底池、脑桥前池、双侧小脑脑桥角、内耳道、第5颈椎水平髓内病变、腰大池病变以及胸段脊髓继发性脊髓空洞症处有大量环形强化囊性病变。组织病理学检查证实为囊尾蚴病。经阿苯达唑治疗和手术切除后，她仍在更高水平出现复发性脊髓受压和梗阻性脑积水。最终，她死于癫痫持续状态和感染性休克。
