Yangang Wang, Weiping Liu and Xiaosheng He*
Department of Neurosurgery, Xijing Hospital, Air Force Military Medical University, ChinaFulltext PDF
We investigated an easy-to-be-confused cerebral lesion finally diagnosed as sparganosis. A 14 yearold- girl was described, who presented repeated focal movement seizures involving her left upper limb (Jackson’s epilepsy) with secondary general epilepsy followed by mild paralysis of this extremity for several minutes (Todd Paralysis). Head CT showed higher density foci under the cortex of the right parietal lobe and MRI showed an irregular enhanced multi-cystic nodular lesion with extensive perilesional edema. Right parietal craniotomy was performed with aid of neuronavigation to remove the lesion. Within the lesion a living parasite was observed, white, flat, banded, 8.5 cm long, wriggling from one end to the opposite. Etiological examination confirmed a pleroceroid (spirometra mansoni). The postoperative follow-up for half a year demonstrated that the patient did not present epileptic seizures and the cerebral lesion disappeared in image examination. Cerebral sparganosis is a rare parasitic disease caused by sparganum. Lacking specific manifestations, differentiation of cerebral sparganosis from inflammatory or neo-plastic lesion within the brain is difficult. Its clinical manifestations include chronic headache, and specific symptoms such as epilepsy, hemiplegia, and aphasia. Immunological test of serum indicates positive antibodies to sparganum mansoni. Final diagnosis depends mainly on pathogen test that requires surgical procedures to perform a biopsy. Surgical resection of the sparganum contributes much more than only use of medicine to effective treatment. Furthermore, removal of the parasite and its surrounding inflammatory granuloma is the most preferred method to control epilepsy due to the cerebral sparganosis.
Sparganosis; Cerebral Lesion; Seizures; Parasite; Surgery
Wang Y, Liu W, He X. Pediatric Epilepsy Induced by a Living Parasite Etiologically Diagnosed as Cerebral Sparganosis. Clin Surg. 2019; 4: 2349.