Eosinophilic Myelitis in the Cervical Cord Mimicking Intramedullary Cord Tumor

Eosinophilic myelitis (EM) or atopic myelitis is a rare disease characterized by a myelitic condition in the spinal cord combined with allergic process. This disease has specific features of elevated serum IgE level, active reaction to mite specific antigen and stepwise progression of mostly the sensory symptoms. Toxocariasis can be related with a form of EM. This report describes two cases of cervical eosinophilic myelitis initially considered as intramedullary tumors. When a differential diagnosis of the intramedullary spinal cord lesion is in doubt, evaluation for eosinophilic myelitis and toxocariasis would be beneficial.

Eosinophilic Myelitis Associated With Toxocariasis

Infection with Toxocara canis evokes various symptoms by migration of the larva via hematogenic infiltration, but CNS involvement has rarely been documented. We describe a 63-year-old man who had eosinophilic myelitis associated with T. canis. He had subacute progressive lower body paresthesia. Spine MR revealed that the intramedullary lesion was in the thoracic cord. CSF analysis showed many eosinophils and elevated antibody titers to T. canis. These results indicate that parasitic infection should be considered as a possible cause of subacute myelitis.