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星空下的噩梦——治疗神经囊尾蚴性脑炎,路在何方。

Nightmares with a starry sky - Treating neurocysticercal encephalitis, how far to go.

作者信息

Ghosal Anirban, Bhattacharya Kajari, Shobhana A, Saraff Rashmi

机构信息

Department of Neurology, Institute of Neurosciences, Kolkata, West Bengal, India.

Department of Neuroradiology, Institute of Neurosciences, Kolkata, West Bengal, India.

出版信息

Trop Parasitol. 2020 Jul-Dec;10(2):158-162. doi: 10.4103/tp.TP_65_20. Epub 2021 Jan 25.

DOI:10.4103/tp.TP_65_20
PMID:33747887
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7951064/
Abstract

Cysticercosis, an infection caused by the larval stage of tapeworm , is the most common parasitic disease of the human nervous system and the single most common cause of acquired epileptic seizures in the developing world. Here, we describe the stormy course of a 67-year-old female with neurocysticercosis (NCC) having a recurrent encephalitic presentation. She went through the most severe spectrum of this disease, namely NCC encephalitis and disseminated cysticercosis and had a classical starry sky brain in neuroimaging. In contrary to the popular practice of avoiding antihelminthic drugs in such extreme presentation, as a desperate measure, we had to use albendazole in this case, which showed clinical and radiological improvement.

摘要

囊尾蚴病是由绦虫幼虫阶段引起的一种感染,是人类神经系统最常见的寄生虫病,也是发展中世界后天性癫痫发作的唯一最常见原因。在此,我们描述了一名67岁患有神经囊尾蚴病(NCC)且反复出现脑炎表现的女性的波折病程。她经历了该病最严重的阶段,即NCC脑炎和播散性囊尾蚴病,神经影像学检查显示典型的“星空脑”。与在这种极端情况下避免使用抗蠕虫药物的普遍做法相反,作为一种孤注一掷的措施,我们在该病例中不得不使用阿苯达唑,结果显示临床和影像学均有改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c66f/7951064/9f318ddbd8c2/TP-10-158-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c66f/7951064/15d804cd2574/TP-10-158-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c66f/7951064/557e206ee79d/TP-10-158-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c66f/7951064/7fa78d69c6f2/TP-10-158-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c66f/7951064/9f318ddbd8c2/TP-10-158-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c66f/7951064/15d804cd2574/TP-10-158-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c66f/7951064/557e206ee79d/TP-10-158-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c66f/7951064/7fa78d69c6f2/TP-10-158-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c66f/7951064/9f318ddbd8c2/TP-10-158-g004.jpg

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本文引用的文献

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BMC Infect Dis. 2020 Mar 14;20(1):220. doi: 10.1186/s12879-020-4891-5.
2
Diagnosis and Treatment of Neurocysticercosis: 2017 Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH).神经囊尾蚴病的诊断与治疗:美国传染病学会(IDSA)和美国热带医学与卫生学会(ASTMH)2017年临床实践指南。
Clin Infect Dis. 2018 Apr 3;66(8):e49-e75. doi: 10.1093/cid/cix1084.
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Cysticercosis of the eye.
眼部囊尾蚴病
Int J Ophthalmol. 2017 Aug 18;10(8):1319-1324. doi: 10.18240/ijo.2017.08.21. eCollection 2017.
4
Disseminated cysticercosis: clinical spectrum, Toll-like receptor-4 gene polymorphisms and role of albendazole: A prospective follow-up of 60 cases with a review of 56 published cases.播散性囊尾蚴病:临床谱、Toll样受体4基因多态性及阿苯达唑的作用:60例前瞻性随访并复习56例已发表病例
Medicine (Baltimore). 2016 Sep;95(39):e4882. doi: 10.1097/MD.0000000000004882.
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Managing neurocysticercosis: challenges and solutions.神经囊尾蚴病的管理:挑战与解决方案
Int J Gen Med. 2015 Oct 16;8:333-44. doi: 10.2147/IJGM.S73249. eCollection 2015.
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Disseminated cysticercosis: a case report and review of the literature.播散性囊尾蚴病:一例病例报告及文献综述
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