Onoe Sachiko
Departament of Pediatrics, Dr Rafael Lucio Central Specialized Medical Hospital, Xalapa, Veracruz, Mexico.
No To Hattatsu. 2005 Jul;37(4):317-21.
Neurocysticercosis is common in Asia, Africa and South America including Mexico. A diagnosis of neurocysticercosis was made neuroradiologically in an 8-year-old Mexican girl, who had suffered from learning difficulties for a year, and subsequently developed headache, vomiting, gait disturbance, visual hallucination, apraxia and euphoric state for 4 months. Plain CT demonstrated numerous cystic lesions with or without scolex in addition to calcified lesions. The lesions were seen throughout the whole brain, although they were relatively scarce in the cerebellum and the lateral ventricular system. Although edema was prominent around the bilateral ventricles, neither ventricular dilatation, midline shift nor inflammatory reaction around the cysts was detected. The patient was treated with albendazole for a month and with steroid for two months. Headache and vomiting disappeared in the first week of treatment but other symptoms persisted, with fluctuation. CT after 2 months of treatment showed dilatations of the third and lateral ventricles. Despite massive infection in the brain, the clinical picture at onset was mild and compatible with nonencephalitic cerebral cysticercosis. The symptoms might be caused by the progressive hydrocephalus due to cerebrospinal fluid blockage, the prognosis of which is predicted to be poor.
神经囊尾蚴病在亚洲、非洲和包括墨西哥在内的南美洲很常见。一名8岁的墨西哥女孩经神经放射学诊断为神经囊尾蚴病,她有一年的学习困难史,随后出现头痛、呕吐、步态障碍、视幻觉、失用症和欣快状态达4个月。平扫CT显示除钙化灶外还有许多有或没有头节的囊性病变。这些病变见于全脑,尽管在小脑和侧脑室系统相对较少。虽然双侧脑室周围水肿明显,但未检测到脑室扩张、中线移位或囊肿周围的炎症反应。患者接受了一个月的阿苯达唑治疗和两个月的类固醇治疗。治疗第一周头痛和呕吐消失,但其他症状持续存在且有波动。治疗2个月后的CT显示第三脑室和侧脑室扩张。尽管脑部有大量感染,但起病时的临床表现较轻,符合非脑炎型脑囊尾蚴病。症状可能是由于脑脊液阻塞导致的进行性脑积水引起的,预计其预后较差。