Coulibaly B, Gautier G, Fuentes S, Ranque S, Bouvier C
Service d'anatomie pathologique et de neuropathologie, CHU La Timone, 264, rue Saint-Pierre, 13385 Marseille, France.
Rev Neurol (Paris). 2008 Nov;164(11):948-52. doi: 10.1016/j.neurol.2008.03.019. Epub 2008 May 13.
Neurocysticercosis is the most common parasitic disease of the central nervous system. It has a worldwide distribution.
We report the case of a 70-year-old woman from Guadeloupe presenting gait abnormalities, impaired ideation, right hemiparesis in a context of weight loss, and fatigue. Blood analyses were normal with neither inflammatory syndrome nor blood hypereosinophilia. Brain computed tomography and magnetic resonance imaging showed hydrocephaly in relation with Sylvius' aqueduc stenosis, and diffuse contrast-enhancing lesions suggesting metastases. Because of clinical symptoms, the patient underwent ventriculostomy; the cerebral spinal fluid examination was normal. Then a frontal biopsy was performed. Histological examination was compatible with neurocysticercosis and confirmed by serology. The patient was successfully treated with albendazole and steroids.
Neurocysticercosis must be considered as a differential diagnosis of cerebral metastasis, especially in patients from endemic countries.
神经囊尾蚴病是中枢神经系统最常见的寄生虫病。它在全球范围内均有分布。
我们报告一例来自瓜德罗普岛的70岁女性病例，该患者存在步态异常、思维能力受损、在体重减轻和疲劳的情况下出现右侧偏瘫。血液分析正常，既无炎症综合征也无血液嗜酸性粒细胞增多。脑部计算机断层扫描和磁共振成像显示与中脑导水管狭窄相关的脑积水，以及提示转移瘤的弥漫性强化病变。由于临床症状，患者接受了脑室造瘘术；脑脊液检查正常。随后进行了额叶活检。组织学检查结果与神经囊尾蚴病相符，并通过血清学得到证实。患者接受阿苯达唑和类固醇治疗后成功康复。
神经囊尾蚴病必须被视为脑转移瘤的鉴别诊断之一，尤其是在来自流行地区的患者中。
