Department of Parasitology, Victor Babes University of Medicine and Pharmacy,5 Vasile Lucaciu Street, Timisoara, Romania.
Foodborne Pathog Dis. 2011 May;8(5):579-85. doi: 10.1089/fpd.2010.0733. Epub 2010 Dec 27.
Neurological involvement may occur in 0.2%-52% of cases with trichinellosis, generally in the most severely affected patients. This review focuses on neurotrichinellosis and includes a brief overview of selected cases reported in the literature. Our primary goal was to increase the awareness of infectious diseases specialists, neurologists, and general practitioners about these major complications with possible fatal outcome. Seventy seven of the cases, for which enough details were available, have been pooled for statistical analysis. The mean age of the investigated group was 34.6 ± 16.8 years. Patients with both focal and diffuse manifestations predominated (55.8%), and they were significantly older (40 ± 15.5 years old) than those who presented solely focal (28.9 ± 17.8 years old; p = 0.03) or diffuse lesions (27.9 ± 15.3 years old; p = 0.007). In most of the cases (59.7%), complete recovery was reported, whereas 23.4% of cases had sequelae and 16.9% of the patients died. Patients who died had significantly lower eosinophil counts (13.8% ± 14%) when compared with those who made complete recovery (28.7% ± 18%; p = 0.015) and the cases with sequelae (35% ± 17.9%; p = 0.006). To sum up, trichinellosis must be considered in the differential diagnosis of any patient with encephalitis or other central nervous system malady of ambiguous etiology.
神经系统受累可发生于旋毛虫病的 0.2%-52%的病例中，通常见于病情最严重的患者。本综述重点关注神经旋毛虫病，并包括对文献中报道的一些精选病例的简要概述。我们的主要目标是提高传染病专家、神经科医生和全科医生对这些可能导致致命后果的主要并发症的认识。对有足够详细资料的 77 例病例进行了汇总分析。研究组的平均年龄为 34.6±16.8 岁。局灶性和弥漫性表现的患者居多（55.8%），且明显比仅表现为局灶性（28.9±17.8 岁；p=0.03）或弥漫性病变（27.9±15.3 岁；p=0.007）的患者年龄更大（40±15.5 岁）。大多数病例（59.7%）报告完全恢复，23.4%的病例有后遗症，16.9%的患者死亡。与完全恢复的患者（28.7%±18%；p=0.015）和有后遗症的患者（35%±17.9%；p=0.006）相比，死亡患者的嗜酸性粒细胞计数明显较低（13.8%±14%）。总之，任何脑炎或其他病因不明的中枢神经系统疾病患者，都应考虑旋毛虫病的鉴别诊断。
