Neurochagas: Experimental and human literature of an uncommon entity (Review)

Neurochagas, the neurological manifestation of Chagas disease, presents a challenge to global health, affecting millions of individuals worldwide. Despite significant progress being made in the understanding of the pathogenesis and clinical presentation of neurochagas, numerous gaps persist in the literature, hindering effective diagnosis and management. The present review discusses the relevant experimental and human literature regarding neurochagas and its epidemiology, pathophysiology, clinical manifestations, diagnostic approaches, treatment strategies and future directions for research. Neurochagas includes a broad spectrum of neurological manifestations, including meningoencephalitis, stroke-like syndromes, cognitive impairment, movement disorders, peripheral neuropathy and autonomic dysfunction, resulting from Trypanosoma cruzi invasion and neuroinflammatory responses. Diagnosing this neurozoonotic disease relies on a multidimensional approach, incorporating clinical evaluation, serological testing, neuroimaging studies, cerebrospinal fluid analysis and ancillary tests. Treatment strategies for neurochagas focus on antiparasitic therapy, symptomatic management, immunomodulation and supportive care. However, available clinical evidence and evidence of proper nervous system penetration is limited, particularly for advanced neurological complications. Future studies are required in order to advance the understanding of the disease mechanisms, identifying biomarkers for early diagnosis and treatment response assessment, developing novel therapeutic interventions, implementing precision medicine approaches, and strengthening global health initiatives to reduce the burden of neurochagas.