Clinical studies on cerebral schistosomiasis japonica in the Philippines

The author examined the cerebral schistosomiasis japonica (CSJ) in the Philippines which is one of the areas heavily infected with S. japonicum. Seventy-five subjects were selected randomly from 307 patients with CSJ, who showed neurological symptoms such as convulsions, paroxysmal disturbance of consciousness and hemiparesis. The mean age of the subjects was 33. Of the 71 patients who had paroxysmal disease, 54 had convulsions, in 33 of which it was of the Jacksonian type, and 24 had psychomotor seizures and 1 autonomic seizures. Thus, 58 patients or 82% of the paroxysmal disease group showed a sign of the localized lesion of the brain. Fifty-one patients (72%) of this group had attacks more than once a month, and the onset of the paroxysmal disease was later than 20 years old in 49 (69%). EEGs were judged as abnormal in 24 (32% of total subjects), borderline in 13 (17%) and normal in 38 (51%). The characteristic abnormal or borderline findings of EEG were random and paroxysmal slow waves with asymmetry. Discussion was made in reference to the strong suspicion that the cerebral symptoms of the subjects, the paroxysmal diseases in particular, were a syndrome associated with Schistosoma japonicum and to the difference between CSJ in Japan and that in the Philippines.