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dc.contributor.authorRoss, Allen G
dc.contributor.authorMcManus, Donald P
dc.contributor.authorFarrar, Jeremy
dc.contributor.authorHunstman, Richard J
dc.contributor.authorGray, Darren J
dc.contributor.authorLi, Yue-Sheng
dc.date.accessioned2017-05-03T14:01:26Z
dc.date.available2017-05-03T14:01:26Z
dc.date.issued2012
dc.date.modified2013-08-29T22:04:23Z
dc.identifier.issn0340-5354
dc.identifier.doi10.1007/s00415-011-6133-7
dc.identifier.urihttp://hdl.handle.net/10072/41165
dc.description.abstractSchistosomiasis (bilharzia) is a neglected tropical disease caused by digenetic trematode platyhelminths of the genus Schistosoma. Neuroschistosomiasis is one of the most severe clinical outcomes associated with schistosome infection. Neurological complications early during the course of infection are thought to occur through in situ egg deposition following aberrant migration of adult worms to the brain or spinal cord. The presence of eggs in the CNS induces a cell-mediated Th2-driven periovular granulomatous reaction. The mass effect of thousands of eggs and the large granulomas concentrated within the brain or spinal cord explain the signs and symptoms of increased intracranial pressure, myelopathy, radiculopathy and subsequent clinical sequelae. Myelopathy (acute transverse myelitis and subacute myeloradiculopathy) of the lumbosacral region is the most common neurological manifestation of S. mansoni or S. haematobium infection, whereas acute encephalitis of the cortex, subcortical white matter, basal ganglia or internal capsule is typical of S. japonicum infection. Cerebral complications include encephalopathy with headache, visual impairment, delirium, seizures, motor deficits and ataxia, whereas spinal symptoms include lumbar pain, lower limb radicular pain, muscle weakness, sensory loss and bladder dysfunction. The finding of eggs in the stool or a positive serology, provides supportive but not direct evidence of neuroschistosomiasis. A definitive diagnosis can only be made with histopathological study showing Schistosoma eggs and granulomas. Schistosomicidal drugs (notably praziquantel), steroids and surgery are currently used for the treatment of neuroschistosomiasis. During the 'acute phase' of the disease, neuroschistosomiasis is treated with corticosteroids which are augmented with a course of praziquantel once female worm ovipositioning commences. Surgery should be reserved for special cases such as in those with evidence of medullary compression and in those who deteriorate despite clinical management.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.languageEnglish
dc.language.isoeng
dc.publisherDr. Dietrich Steinkopff Verlag
dc.publisher.placeGermany
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom22
dc.relation.ispartofpageto32
dc.relation.ispartofissue1
dc.relation.ispartofjournalJournal of Neurology
dc.relation.ispartofvolume259
dc.rights.retentionY
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchMedical parasitology
dc.subject.fieldofresearchNeurosciences
dc.subject.fieldofresearchcode3202
dc.subject.fieldofresearchcode320704
dc.subject.fieldofresearchcode3209
dc.titleNeuroschistosomiasis
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.facultyGriffith Health, School of Public Health
gro.date.issued2012
gro.hasfulltextNo Full Text
gro.griffith.authorRoss, Allen G.


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