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Spinal schistosomiasis: Cases in Egyptian population
Ahmed M Ashour1, Tarek H Elserry1, Mohamed S Nosser1
1Department of Neurosurgery, School of Medicine, Ain Shams University, Abbasia Square, Cairo, Egypt.
Journal of Craniovertebral Junction & Spine
|May 15, 2018
Summary
Spinal schistosomiasis, though rare, can cause severe neurological deficits. Early diagnosis and a combination of surgical decompression, steroids, and praziquantel are crucial for managing this parasitic infection of the spinal cord.
Area of Science:
- Neurology
- Infectious Diseases
- Parasitology
Background:
- Spinal cord schistosomiasis is a rare parasitic infection.
- Clinical manifestations range from radicular pain to severe myelopathy, including paraplegia and incontinence.
Observation:
- A retrospective analysis of six confirmed spinal schistosomiasis cases over 20 years.
- The majority of patients were male, with an average age of 26.
- All patients presented with motor deficits, and half experienced sphincter disturbances or back pain.
Findings:
- Surgical intervention (decompression laminectomy with biopsy or excision) was performed on all patients.
- Complete surgical excision was possible in only 33.33% of cases due to ill-defined, adherent lesions.
- All patients received steroid therapy and repeated cycles of praziquantel post-surgery.
Implications:
- A history of travel to endemic areas is key for diagnosing spinal schistosomiasis, especially with conus/epiconus lesions.
- Surgical decompression and treatment with steroids and praziquantel offer the best management strategy.
- This approach aids in diagnosis, treatment, and exclusion of other spinal pathologies.
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