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[Micturition dysfunction triggered by spinal intramedullary neurocysticercosis]
J-H Egberts1, C van der Horst, A Bannowsky
1Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel. jegberts@urology.uni-kiel.de
Aktuelle Urologie
|March 5, 2004
Summary
This case report details a rare intramedullary spinal neurocysticercosis in a young man, highlighting diagnostic challenges and long-term bladder dysfunction. Early consideration of neurocysticercosis is crucial for patients with neurological symptoms and travel history.
Area of Science:
- Neurology
- Infectious Diseases
- Parasitology
Background:
- Neurocysticercosis is the most common parasitic infection of the human nervous system.
- This report focuses on the rare intramedullary spinal form of neurocysticercosis.
Observation:
- A 26-year-old male presented with arm paralysis and progressive bladder dysfunction.
- Cervical MRI revealed a large intramedullary spinal cord lesion, later confirmed as neurocysticercosis.
- Multiple smaller intramedullary lesions and a conus medullaris lesion were also identified.
Findings:
- Histological examination confirmed parasitic structures consistent with neurocysticercosis.
- The patient developed severe bladder dysfunction (hyposensible, hypercontractile, unstable detrusor) requiring catheterization.
- Subtle early neurological symptoms were noted retrospectively, with probable infection acquired 20 years prior in South America.
Implications:
- Diagnosing neurocysticercosis is challenging, particularly in non-endemic regions like Europe.
- Neurocysticercosis should be considered in the differential diagnosis for intraspinal tumors, especially with non-specific neurological symptoms and a history of travel to endemic areas.
- Delayed diagnosis can lead to significant neurological deficits and chronic bladder dysfunction.