Sánchez Sofia S, García Hector H, Nicoletti Alessandra
Department of Microbiology, School of Public Health (SSS), Center for Global Health - Tumbes (HHG), Universidad Peruana Cayetano Heredia, Lima, Peru.
School of Sciences (HHG), Center for Global Health - Tumbes (HHG), Universidad Peruana Cayetano Heredia, Lima, Peru.
Front Neurol. 2018 Feb 8;9:53. doi: 10.3389/fneur.2018.00053. eCollection 2018.
Human toxocariasis is one of the most prevalent helminthiases worldwide. larvae can cross the blood-brain barrier leading to the neurotoxocariasis. The clinical presentation consists of a wide spectrum of neurological manifestations, but asymptomatic infection is probably common. Neurotoxocariasis is not a frequent diagnosis probably due to the non-specific nature of its symptoms as well as the lack of confirmatory diagnostic tests. Diagnosis of neurotoxocariasis is based on the presence of a high titer of anti- antibody in the cerebrospinal fluid or in the serum, presence of eosinophilia in the serum or cerebrospinal fluid, and clinical and radiological improvement after anthelmintic therapy; however, universally accepted diagnostic criteria are lacking. Magnetic resonance imaging (MRI) findings include single or multiple, subcortical, cortical or white matter hyperintense lesions, best visualized on FLAIR and T2-weighted imaging, and usually isointense or hypointense on T1. These imaging findings are suggestive but not specific to neurotoxocariasis. Definitive diagnosis is made by histological confirmation, but it is rarely followed. This review provides an overview of the clinical manifestations, management options, and MRI findings of neurotoxocariasis.
人体弓首蛔虫病是全球最普遍的蠕虫病之一。幼虫可穿过血脑屏障,导致神经弓首蛔虫病。临床表现包括广泛的神经学表现,但无症状感染可能很常见。神经弓首蛔虫病可能不是一个常见的诊断,这可能是由于其症状的非特异性以及缺乏确诊的诊断测试。神经弓首蛔虫病的诊断基于脑脊液或血清中高滴度抗体的存在、血清或脑脊液中嗜酸性粒细胞增多,以及驱虫治疗后临床和影像学改善;然而,目前缺乏普遍接受的诊断标准。磁共振成像(MRI)表现包括单发或多发、皮质下、皮质或白质高信号病变,在液体衰减反转恢复序列(FLAIR)和T2加权成像上显示最佳,在T1加权成像上通常等信号或低信号。这些影像学表现提示神经弓首蛔虫病,但不具有特异性。确诊需经组织学证实,但很少进行。本文综述了神经弓首蛔虫病的临床表现、治疗选择和MRI表现。