Hong Van Pham, Quang Thieu Nguyen, Ba Loi Cao, Minh Xuan Ngo, Quang Huy Huynh
General Planning Department, National Hospital of Traditional Medicine, Hanoi, VNM.
Parasitic Infectious Department, National Institute of Malariology/Parasitology and Entomology, Hanoi, VNM.
Cureus. 2020 May 16;12(5):e8153. doi: 10.7759/cureus.8153.
Cerebral cysticercosis is the most common parasitic disease of the human nervous system. It is endemic to some tropical countries but has rarely been described in Vietnam. We report three cases of neurocysticercosis in patients from north-west Vietnam presenting with recurrent epileptic seizures. Hypereosinophilia and positive immunoglobulin G (IgG) antibodies to cysticercosis were detected in two patients and three patients, respectively. The brain MRI showed multiple ring-enhancing cerebral lesions with a well-defined border. Scolexes were demonstrated on fluid attenuation inversion recovery (FLAIR) sequence as small images associated with a hyperintense cyst wall. Treatment of cerebral cysticercosis infection with albendazole 15 mg/kg/day x 21 days along with antiepileptic drug therapy usually results in a favorable outcome. These results highlight that cerebral cysticercosis should be suspected in patients from an endemic area who present with headaches and/or epileptic seizures.
脑囊尾蚴病是人类神经系统最常见的寄生虫病。该病在一些热带国家呈地方性流行,但在越南鲜有报道。我们报告了3例来自越南北部的神经囊尾蚴病患者,他们均表现为反复癫痫发作。分别在2例和3例患者中检测到嗜酸性粒细胞增多和抗囊尾蚴病免疫球蛋白G(IgG)抗体阳性。脑部MRI显示多个边界清晰的环形强化脑病变。在液体衰减反转恢复(FLAIR)序列上可显示头节,表现为与高信号囊壁相关的小图像。用阿苯达唑15mg/kg/天,共21天治疗脑囊尾蚴病感染,并联合抗癫痫药物治疗,通常会取得良好疗效。这些结果表明,对于来自流行地区且出现头痛和/或癫痫发作的患者,应怀疑患有脑囊尾蚴病。