Schistosomiasis of the spinal cord

Four cases of spinal cord schistosomiasis were characterized by paraparesis, sensory loss, and sphincter disturbances progressing over hours to days. One patient showed deterioration over months and remission after laminectomy, followed by the typical, rapidly progressive deficits. Biopsies on two patients showed granulomatous and necrotizing myelitis. Spontaneous improvement and unremitting deterioration, despite chemotherapy, make evaluation of treatment difficult. A survey of all previously reported cases provided no consistent pattern of response to any treatment modalities. Laminectomy for decompression and diagnosis, administration of antischistosomal medications, and high-dose oral prednisone early in the illness are recommended.