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April 1989

Inflammatory Arteriopathies and Pure Motor Hemiplegia

Author Affiliations

División de Neurología Instituto Nacional de Neurologia y Neurocirugía Insurgentes Sur 3877 CP 14410 México 22 DF, México

Arch Neurol. 1989;46(4):361. doi:10.1001/archneur.1989.00520400015009

To the Editor.  —We have read with interest the article by Johns et al1 on meningovascular neurosyphilis and pure motor hemiplegia. While we found the information of value since it increases our knowledge about the causes of this lacunar syndrome, we think that one of the authors' statements should be reconsidered: "... among the inflammatory arteriopathies, only syphilis and tuberculosis are associated with meningitis."Cysticercosis, the most common parasitic disease of the central nervous system,2 is a well-recognized cause of both inflammatory arteriopathy and meningitis.2,3 Meningeal cysticerci usually induce subacute, chronic, or recurrent meningitis with affection of blood vessels near the parasites. Those vessels show thickening of the adventitia with fibrosis of the media and endothelial hyperplasia3; a brain infarction may be the result of this vascular involvement.4,5 Therefore, cysticercosis should be recognized not only as a possible, but as a frequent, cause of ischemic cerebrovascular