Othman Ahmad A, Bruschi Fabrizio, Ganna Ahmed A
J Egypt Soc Parasitol. 2014 Apr;44(1):55-70. doi: 10.12816/0006446.
Helminth parasitic infections of the central nervous system (CNS) occur worldwide with high prevalence in tropical and subtropical countries. Clinical evaluation of patients is mandatory, and it is convenient to group the clinical manifestations into syndromes: for example space-occupying lesions, meningitis, and encephalitis. The history should focus on residence or travel to endemic areas, diet, activities, intercurrent medical conditions, and associated clinical clues. Direct parasitological diagnosis can be reached by cerebrospinal fluid and cerebral tissue examination either by microscopy, culture, or immunological techniques. Immunodiagnosis by detection of parasite antibodies or antigens in serum could provide indirect evidence of parasitic infections. In addition, various imaging and radiological techniques e.g., computed tomography (CT) scan and magnetic resonance imaging (MRI) complement the diagnostic work-up of CNS diseases. Finally, the helminthic CNS infections of global impact, such as schistosomiasis, neurotoxocariasis, Strongyloides infection, neurotrichinosis, neurocysticercosis, and echinococcosis will be briefly discussed as regards the principal clinical and diagnostic features.
中枢神经系统（CNS）的蠕虫寄生虫感染在全球范围内均有发生，在热带和亚热带国家的患病率很高。对患者进行临床评估是必要的，将临床表现归为综合征很方便：例如占位性病变、脑膜炎和脑炎。病史应重点关注在流行地区的居住或旅行情况、饮食、活动、并发疾病以及相关的临床线索。通过显微镜检查、培养或免疫技术对脑脊液和脑组织进行检查可实现直接寄生虫学诊断。通过检测血清中的寄生虫抗体或抗原进行免疫诊断可为寄生虫感染提供间接证据。此外，各种影像学和放射学技术，如计算机断层扫描（CT）和磁共振成像（MRI），可辅助中枢神经系统疾病的诊断检查。最后，将简要讨论对全球有影响的蠕虫性中枢神经系统感染，如血吸虫病、神经弓蛔虫病、类圆线虫感染、神经旋毛虫病、神经囊尾蚴病和棘球蚴病的主要临床和诊断特征。
