Cisse F A, Morel Y, Bangoura M A, Jedou A, Basse A, Ndiaye M, Diop A G, Ndiaye M M, Cisse A
Clinique Neurologique, CHU de Fann, Dakar, Sénégal.
Rev Med Interne. 2012 Oct;33(10):580-2. doi: 10.1016/j.revmed.2012.06.005. Epub 2012 Jul 19.
Neurological complications of schistosomiasis remain exceptional even in hyperendemic area.
We report a 26-year-old Senegalese man, without past medical history, who was admitted for spastic paraplegia, acute retention of urine, and pain in low back and lower limbs. The final diagnosis was spinal cord schistosomiasis. Diagnosis was based on the endemic context, MRI medullar conus imaging, schistosoma serology in cerebrospinal fluid and blood, and the absence of other cause of myelopathy. Treatment was based on praziquantel, corticosteroids and physiotherapy. The outcome was favorable after a 2-year follow-up.
Schistosomiasis should be included in the differential diagnosis of myelopathy in patients living actually, or even traveled in the past, in endemic tropical areas.
即使在血吸虫病高度流行地区,其神经系统并发症仍然罕见。
我们报告一名26岁的塞内加尔男子,既往无病史,因痉挛性截瘫、急性尿潴留以及腰和下肢疼痛入院。最终诊断为脊髓血吸虫病。诊断依据为流行情况、脊髓圆锥MRI成像、脑脊液和血液中的血吸虫血清学检查以及无其他脊髓病病因。治疗采用吡喹酮、皮质类固醇和物理治疗。经过2年随访,结果良好。
对于目前居住在或过去曾前往热带流行地区的脊髓病患者,血吸虫病应纳入鉴别诊断。