Peregrino, et al. [Diagnosis of schistosomiasis of the spinal cord: contribution of magnetic resonance imaging and electroneuromyography]

[Wise Young]

• Peregrino AJ, Puglia PM, Bacheschi LA, Hirata MT, Brotto MW, Nobrega JP and Scaff M (2002). [Diagnosis of schistosomiasis of the spinal cord: contribution of magnetic resonance imaging and electroneuromyography]. Arq Neuropsiquiatr 60:597-602. Summary: OBJECTIVE: To analyze the usefulness of magnetic resonance imaging MRI and electroneuromyography (ENMG) in the diagnosis of schistosomiasis of the spinal cord (SSC). METHOD: 18 MRI of the thoracolumbar spine and 24 ENMG of the upper and lower limbs were carried out on patients with a definite diagnosis of SSC in the clinical forms of myeloradiculitis or thoracic transverse myelitis. RESULTS: Of the 18 MRI carried out, 16 (88.8%) showed abnormalities on T1 and T2 weighted images and heterogenous pattern of enhancement with contrast material injection. Of the 24 ENMG, 23 (95.8%) showed a feature of bilateral multiradiculopathy of roots L2, L3, L4, L5, S1, S2, asymmetric in 10 cases (41.6%), characterized by signs of denervation in the lumbar paraspinal musculature and long duration polyphasic potentials in increased proportion, as well decrease of the recruitment of motor units. CONCLUSION: In spite of the non-specificity of both exams, the MRI and the ENMG showed to be useful for the diagnosis of SSC, by revealing abnormalities that repeated in 88.8% and 95.8% of the cases, respectively. Divisao de Neurologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil. peregrino@nanet.com.br

[Wise Young]

• Olson S, Rossato R and Guazzo E (2002). Spinal schistosomiasis. J Clin Neurosci 9:317-20. Summary: A 23 year old female presented to Townsville General Hospital seven months after a positive urine test for Schistosomiasis with conus modularize signs. MRI confirmed a conus medullaris enhancing lesion. Serology was positive for Schistosoma IgG : IgM, 3.4 : 1.8. Urine screening for ova, stool sample, rectal biopsy and diagnostic investigations were negative. She was treated empirically for Schistosoma without biopsy with marked resolution of her symptoms and signs. She remains neurologically well one year after presentation. Serological identification from the Centre of Disease Control and Prevention in Atlanta Georgia by western blot has shown positive IgG for Schistosoma haematobium and mansoni. Schistosoma myelopathy is a rare cause of transverse myelitis, conus medullaris syndrome, anterior spinal artery occlusion and radiculopathy in Australia. It should however be included in the differential diagnosis in a patient who has been in or presenting from an endemic area. Townsville General Hospital, Eyre Street, North Ward, Townsville, Queensland, 4810, Australia. sarahl_olson@hotmail.com