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Images in Neurology
September 2011

Schistosoma mansoni Encephalomyelitis

Author Affiliations

Author Affiliations: Neurology Division (Drs Vale, Marques, and de Sousa-Pereira) and Infectious Diseases Division (Dr Lambertucci), Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

Arch Neurol. 2011;68(9):1200-1201. doi:10.1001/archneurol.2011.198

A 27-year-old Brazilian woman had a history of lumbar and lower-limb pain associated with a progressive decrease in muscle strength and paresthesias. Neurological examination findings revealed flaccid paraparesis, lack of patellar and Achilles-tendon bilateral reflexes, and urinary retention. Thoracic and lumbar spinal cord magnetic resonance imaging showed a hyperintense signal extending from T3 to T6. She was diagnosed as having an inflammatory myeloradiculopathy, and corticosteroid therapy was started with partial improvement in her condition. Five months after being discharged from hospital, she was readmitted owing to tonicoclonic seizures and visual impairment. Brain magnetic resonance imaging revealed a right parieto-occipital mass (Figure 1) and a lesion in the left cerebellar hemisphere (Figure 2). Microscopy showed multiple granulomas within which Schistosoma mansoni ova were observed (Figure 3).

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