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April 6, 1963


JAMA. 1963;184(1):56-57. doi:10.1001/jama.1963.03700140112020

Two recent studies add to our understanding of the pathogenesis and variable clinical course of trichinosis. The subject is timely, since I of every 6 Americans harbors Trichinella spiralis and, although the majority of infections are symptomless, it is estimated that 16,000 individuals yearly experience detectable illness. Gray and associates1 reported 3 cases of nonfatal trichinosis with neurologic and cardiac involvement. Cerebral signs and symptoms begin during the second week, which is the larval migratory stage, and the clinical picture is characterized by emotional instability, delirium, headache, and hyporeflexia. These symptoms appear secondary to Trichinella encephalitis, and the resultant syndrome may resemble meningitis. Focal involvement of the central nervous system occurs later, often during the third week, but never before the 14th day. The onset is ordinarily gradual and may be accompanied by such varied signs as hemiplegia, convulsions, polyneuritis, or signs of a space-occupying lesion. Local, neurologic involvement

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