RESUMO
BACKGROUND: Schistosoma mansoni is a parasitic trematoid worm that infects humans. Schistosomiasis is endemic in parts of South America, sub-Saharan Africa, the Middle East, and some Caribbean islands. Disorders of the liver and gastrointestinal tract are the most common clinical manifestations. The central nervous system is not usually affected. The most common neurologic manifestation is transverse myelitis. In some circumstances, the eggs of S. mansoni are found in the brain, causing inflammatory reaction. OBJECTIVE: To describe a young Brazilian patient with partial epileptic seizures caused by a granulomatous lesion due to S. mansoni. CONCLUSION: In endemic areas or in patients with a positive epidemiological history, schistosomiasis must be considered as a possible diagnosis of seizures, particularly when they are associated with granulomatous lesions on magnetic resonance imaging.
Assuntos
Córtex Cerebral/fisiopatologia , Córtex Cerebral/parasitologia , Neuroesquistossomose/diagnóstico , Neuroesquistossomose/fisiopatologia , Convulsões/diagnóstico , Convulsões/parasitologia , Adulto , Humanos , MasculinoRESUMO
Whipple's disease (WD) is an uncommon multisystem condition caused by the bacillus Tropheryma whipplei. Central nervous system involvement is a classical feature of the disease observed in 20 to 40% of the patients. We report the case of a 62 year old man with WD that developed neurological manifestations during its course, and discuss the most usual signs and symptoms focusing on recent diagnostic criteria and novel treatment regimens.
Assuntos
Encefalopatias/etiologia , Doença de Whipple/complicações , Biópsia , Encefalopatias/diagnóstico , Diarreia/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Polineuropatias/diagnóstico , Polineuropatias/microbiologia , Tomografia Computadorizada por Raios X , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Doença de Whipple/diagnóstico , Doença de Whipple/tratamento farmacológicoRESUMO
Hypertrophic pachymeningits is an unusual cause of neurological symptoms and is often secondary to infections, carcinomatosis or inflammatory diseases. It may also be idiopathic. We report a case of pachymeningitis which was manifested primarily by psychosis and visual loss with optic atrophy and destruction of nasal septum. The patient, a 45 year old woman was submitted to extensive investigation without evidence of any underlying disease. A meningeal biopsy was performed and showed a mostly unspecific inflammatory process with extensive fibrosis of the dura and few early stage granulomas. These findings suggest either neurosarcoidosis or idiopathic hypertrophic pachymeningitis.
Assuntos
Meningite/etiologia , Biópsia , Dura-Máter/patologia , Feminino , Gadolínio , Humanos , Hipertrofia , Angiografia por Ressonância Magnética , Meningite/patologia , Pessoa de Meia-Idade , Septo Nasal/patologia , Doenças do Nervo Óptico/complicaçõesRESUMO
São relatados quatro casos de esquistossomose do sistema nervoso central, descrevendo-se os achados radiológicos e sua correlação com a clínica. Em um caso o envolvimento cerebral foi caracterizado por lesão pseudotumoral única, com confirmação anatomopatológica, e três casos de esquistossomose medular foram caracterizados por tumefação medular e impregnação leptomeníngea e radicular do meio de contraste paramagnético. Os achados deste trabalho enfatizam a importância de se considerar a esquistossomose no diagnóstico diferencial de lesões encefálicas ou medulares em pacientes procedentes de áreas endêmicas para a esquistossomose.
