SCHISTOSOMAL MYELORADICULOPATHY IN A NON-ENDEMIC AREA

Area of Science:

• Neurology
• Infectious Diseases
• Parasitology

Background:

• Schistosomiasis is endemic in many regions of Brazil, but has a low incidence in the southern part of the country.
• Schistosomal myeloradiculopathy is the most severe ectopic manifestation of schistosomiasis.
• This condition should be suspected in patients presenting with low back pain, motor or sensory deficits in the lower limbs, or urinary tract disturbances.

Observation:

• An 11-year-old boy presented with acute limb weakness and urinary dysfunction.
• Cerebrospinal fluid analysis revealed eosinophilic meningitis and peripheral eosinophilia.
• Serology confirmed Schistosoma mansoni infection.

Findings:

• The patient received steroids, praziquantel, and physical therapy, showing neurological improvement.
• Despite treatment, the patient has long-term urinary catheter dependence.
• Neurological deficits improved from C6 to T6 medullary level.

Implications:

• Schistosomal myeloradiculopathy should be suspected in patients with neurological and urinary symptoms, even in non-endemic areas.
• Prompt diagnosis and treatment, including antiparasitic drugs and corticosteroids, can mitigate severe neurological sequelae.
• This case highlights the importance of considering ectopic schistosomiasis in differential diagnoses for neurological disorders.