Han Sang-Beom, Kwon Hyon-Jo, Choi Seung-Won, Koh Hyeon-Song, Kim Seon-Hwan, Song Shi-Hun, Youm Jin-Young
Department of Neurosurgery, Chungnam National University School of Medicine, Daejeon, Korea.
Korean J Spine. 2014 Sep;11(3):205-8. doi: 10.14245/kjs.2014.11.3.205. Epub 2014 Sep 30.
Cysticercosis is the most common parasitic disease affecting the central nervous system. Spinal involvement is rare in neurocysticercosis, and isolated spinal involvement without evidence of cranial involvement is even rarer. We report an unusual case of neurocysticercosis with isolated spinal involvement. A 59 year-old male presented with radiating pain in the left leg. He complained of aggravating weakness and numbness in the left leg since his previous visit one month ago. Magnetic resonance imaging (MRI) revealed multiple peripheral wall-enhanced intradural cystic masses from L1 to L5. The patient underwent a total laminectomy of L4. Dissection revealed abnormal cystic masses compressing the nerve roots. The cyst was punctured, spilling clear mucoid fluid into the surgical field. The exposed cysticerci, white and mucoid, was easily removed. Patient received course of steroids and oral albendazole. The patient experienced symptomatic improvement without further neurologic deficits except for mild sensory impairment. Clinicians should include spinal neurocysticercosis in differential diagnosis of radiculopathies. Although isolated spinal neurocysticercosis is rare, it can be satisfactorily managed with surgery and medication.
囊尾蚴病是影响中枢神经系统最常见的寄生虫病。在神经囊尾蚴病中,脊髓受累情况罕见,而无颅内受累证据的孤立性脊髓受累更为罕见。我们报告一例罕见的孤立性脊髓受累的神经囊尾蚴病病例。一名59岁男性因左腿放射性疼痛就诊。他主诉自一个月前上次就诊以来左腿无力和麻木加重。磁共振成像(MRI)显示从L1至L5有多个硬膜内周边强化的囊性肿块。患者接受了L4全椎板切除术。手术解剖发现异常囊性肿块压迫神经根。囊肿被刺破,清亮的黏液样液体流入手术视野。暴露的囊尾蚴呈白色且黏液样,很容易被摘除。患者接受了类固醇治疗疗程及口服阿苯达唑。除轻度感觉障碍外,患者症状改善,未出现进一步神经功能缺损。临床医生应将脊髓神经囊尾蚴病纳入神经根病的鉴别诊断中。虽然孤立性脊髓神经囊尾蚴病罕见,但通过手术和药物治疗可得到满意的处理。