Cerebrospinal fluid analysis in eosinophilic meningoencephalitis

Area of Science:

• Neurology
• Infectious Diseases
• Parasitology

Background:

• Eosinophilic meningoencephalitis (EME) is a significant neurological disease prevalent in Thailand.
• Consumption of raw or undercooked Pila snails is a common risk factor identified in EME cases.
• The disease exhibits a distinct seasonal pattern, primarily occurring between July and January.

Purpose of the Study:

• To analyze cytological specimens and clinical data from 56 EME patients.
• To compare diagnostic yield between fresh cerebrospinal fluid (CSF) and stained CSF sediment.
• To correlate CSF findings with clinical symptoms and disease severity.

Main Methods:

• Retrospective analysis of clinical data from 56 EME patients.
• Cytological examination of both fresh CSF and H&E stained CSF sediment.
• Statistical correlation between eosinophil counts, CSF glucose, protein levels, and intracranial pressure.

Main Results:

• Headache was the most frequent symptom in all EME cases.
• H&E stained CSF sediment showed significantly higher yields of eosinophils and lymphocytes compared to fresh CSF.
• CSF glucose and eosinophil counts were significantly correlated in both fresh and stained CSF specimens.

Conclusions:

• H&E stained CSF sediment is a more sensitive method for detecting eosinophils in EME, particularly in early disease stages.
• CSF analysis reveals significant correlations between eosinophils, glucose, protein, and intracranial pressure.
• Prompt diagnosis and supportive therapy, including spinal taps and corticosteroids, are crucial for managing EME, with no fatal cases reported in this study.