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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Neuroschistosomiasis (NS)
Synonyms
- Bilharziasis
- Katayama fever = acute schistosomiasis
Definitions
- CNS infection from parasitic trematodes (blood flukes) of genus Schistosoma
- Complex life cycle
- Infect particular species of freshwater snails within endemic areas
- Infected snails release free-swimming larvae (cercariae), which attach to host mammal
- Cercariae migrate through skin to dermal veins → pulmonary vasculature
- Cercariae metamorphose to "schistosomula" → losing forked tails, developing lipid teguments, incorporating host proteins (major histocompatibility complexes and blood group antigens)
- Migrate through lung capillaries → portal veins where they mature
- Male and female pair off and migrate together, produce eggs
- S. mansoni, S. japonicum → mesenteric veins
- S. haematobium → vesicular (bladder) veins
- Eggs are antigenic and induce inflammatory response
- Migrate through bowel or bladder wall and shed in feces, urine
- Shed eggs mature into free-swimming "miracidia" → infect freshwater snail
- 2 generations of "sporocysts" multiply in snail intermediate host
IMAGING
General Features
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
- Chauvin A et al: Acute paraplegia due to schistosomiasis: an uncommon cause in developed countries. J Neurovirol. 25(3):434-7, 2019
- Ashour AM et al: Spinal schistosomiasis: cases in Egyptian population. J Craniovertebr Junction Spine. 9(1):76-80, 2018
- Kim JK et al: High-level cervical spinal cord stimulation used to treat intractable pain arising from transverse myelitis caused by schistosomiasis. J Korean Neurosurg Soc. 47(2):151-4, 2010
- Vidal CH et al: Epidemiological aspects in neuroschistosomiasis. Arq Neuropsiquiatr. 68(1):72-5, 2010
- Wang P et al: Research development of the pathogenesis pathways for neuroschistosomiasis. Neurosci Bull. 26(2):168-74, 2010
- Felipe L et al: Vestibular-evoked myogenic potential (VEMP) in the evaluation of schistosomal myeloradiculopathy. Am J Trop Med Hyg. 81(4):551-4, 2009
- Carod-Artal FJ: Neurological complications of Schistosoma infection. Trans R Soc Trop Med Hyg. 102(2):107-16, 2008
- Ferrari TC et al: Immune response and pathogenesis of neuroschistosomiasis mansoni. Acta Trop. 108(2-3):83-8, 2008
- Cohen-Gadol AA et al: Spinal cord biopsy: a review of 38 cases. Neurosurgery. 52(4): 806-15; discussion 815-6, 2003
- Olson S et al: Spinal schistosomiasis. J Clin Neurosci. 9(3):317-20, 2002
- Samandouras G et al: Schistosoma haematobium presenting as an intrinsic conus tumour. Br J Neurosurg. 16(3): 296-300, 2002
- Junker J et al: Cervical intramedullar schistosomiasis as a rare cause of acute tetraparesis. Clin Neurol Neurosurg. 103(1): 39-42, 2001
- Leite CC et al: Clinics in diagnostic imaging (52). Spinal cord schistosomiasis. Singapore Med J. 41(8): 417-9, 2000
- Mazyad MA et al: Spinal cord schistosomiasis and neurologic complications. J Egypt Soc Parasitol. 29(1): 179-82, 1999
- Bennett G et al: Schistosomal myelitis: findings at MR imaging. Eur J Radiol. 27(3): 268-70, 1998
- Murphy KJ et al: Spinal cord infection: myelitis and abscess formation. AJNR Am J Neuroradiol. 19(2): 341-8, 1998
- Pittella JE: Neuroschistosomiasis. Brain Pathol. 7(1): 649-62, 1997
- Ueki K et al: Schistosoma mansoni infection involving the spinal cord. Case report. J Neurosurg. 82(6): 1065-7, 1995
- Haribhai HC et al: Spinal cord schistosomiasis. A clinical, laboratory and radiological study, with a note on therapeutic aspects. Brain. 114 ( Pt 2): 709-26, 1991
- Bloom K et al: Paraplegia from schistosomiasis. Paraplegia. 28(7): 455-9, 1990
- Bac DJ et al: Schistosomiasis in ectopic or unusual sites. A report of 5 cases. S Afr Med J. 72(10): 717-8, 1987
- Scrimgeour EM et al: Involvement of the central nervous system in Schistosoma mansoni and S. haematobium infection. Brain. 108 ( Pt 4):1023-38, 1985
- Queiroz LS et al: Massive spinal cord necrosis in schistosomiasis. Arch Neurol. 36(8): 517-9, 1979
- Norfray JF et al: Schistosomiasis of the spinal cord. Surg Neurol. 9(1): 68-71, 1978
- Siddorn JA: Schistosomiasis and anterior spinal artery occlusion. Am J Trop Med Hyg. 27(3): 532-4, 1978
- Lechtenberg R et al: Schistosomiasis of the spinal cord. Neurology. 27(1): 55-9, 1977
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Neuroschistosomiasis (NS)
Synonyms
- Bilharziasis
- Katayama fever = acute schistosomiasis
Definitions
- CNS infection from parasitic trematodes (blood flukes) of genus Schistosoma
- Complex life cycle
- Infect particular species of freshwater snails within endemic areas
- Infected snails release free-swimming larvae (cercariae), which attach to host mammal
- Cercariae migrate through skin to dermal veins → pulmonary vasculature
- Cercariae metamorphose to "schistosomula" → losing forked tails, developing lipid teguments, incorporating host proteins (major histocompatibility complexes and blood group antigens)
- Migrate through lung capillaries → portal veins where they mature
- Male and female pair off and migrate together, produce eggs
- S. mansoni, S. japonicum → mesenteric veins
- S. haematobium → vesicular (bladder) veins
- Eggs are antigenic and induce inflammatory response
- Migrate through bowel or bladder wall and shed in feces, urine
- Shed eggs mature into free-swimming "miracidia" → infect freshwater snail
- 2 generations of "sporocysts" multiply in snail intermediate host
IMAGING
General Features
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
- Chauvin A et al: Acute paraplegia due to schistosomiasis: an uncommon cause in developed countries. J Neurovirol. 25(3):434-7, 2019
- Ashour AM et al: Spinal schistosomiasis: cases in Egyptian population. J Craniovertebr Junction Spine. 9(1):76-80, 2018
- Kim JK et al: High-level cervical spinal cord stimulation used to treat intractable pain arising from transverse myelitis caused by schistosomiasis. J Korean Neurosurg Soc. 47(2):151-4, 2010
- Vidal CH et al: Epidemiological aspects in neuroschistosomiasis. Arq Neuropsiquiatr. 68(1):72-5, 2010
- Wang P et al: Research development of the pathogenesis pathways for neuroschistosomiasis. Neurosci Bull. 26(2):168-74, 2010
- Felipe L et al: Vestibular-evoked myogenic potential (VEMP) in the evaluation of schistosomal myeloradiculopathy. Am J Trop Med Hyg. 81(4):551-4, 2009
- Carod-Artal FJ: Neurological complications of Schistosoma infection. Trans R Soc Trop Med Hyg. 102(2):107-16, 2008
- Ferrari TC et al: Immune response and pathogenesis of neuroschistosomiasis mansoni. Acta Trop. 108(2-3):83-8, 2008
- Cohen-Gadol AA et al: Spinal cord biopsy: a review of 38 cases. Neurosurgery. 52(4): 806-15; discussion 815-6, 2003
- Olson S et al: Spinal schistosomiasis. J Clin Neurosci. 9(3):317-20, 2002
- Samandouras G et al: Schistosoma haematobium presenting as an intrinsic conus tumour. Br J Neurosurg. 16(3): 296-300, 2002
- Junker J et al: Cervical intramedullar schistosomiasis as a rare cause of acute tetraparesis. Clin Neurol Neurosurg. 103(1): 39-42, 2001
- Leite CC et al: Clinics in diagnostic imaging (52). Spinal cord schistosomiasis. Singapore Med J. 41(8): 417-9, 2000
- Mazyad MA et al: Spinal cord schistosomiasis and neurologic complications. J Egypt Soc Parasitol. 29(1): 179-82, 1999
- Bennett G et al: Schistosomal myelitis: findings at MR imaging. Eur J Radiol. 27(3): 268-70, 1998
- Murphy KJ et al: Spinal cord infection: myelitis and abscess formation. AJNR Am J Neuroradiol. 19(2): 341-8, 1998
- Pittella JE: Neuroschistosomiasis. Brain Pathol. 7(1): 649-62, 1997
- Ueki K et al: Schistosoma mansoni infection involving the spinal cord. Case report. J Neurosurg. 82(6): 1065-7, 1995
- Haribhai HC et al: Spinal cord schistosomiasis. A clinical, laboratory and radiological study, with a note on therapeutic aspects. Brain. 114 ( Pt 2): 709-26, 1991
- Bloom K et al: Paraplegia from schistosomiasis. Paraplegia. 28(7): 455-9, 1990
- Bac DJ et al: Schistosomiasis in ectopic or unusual sites. A report of 5 cases. S Afr Med J. 72(10): 717-8, 1987
- Scrimgeour EM et al: Involvement of the central nervous system in Schistosoma mansoni and S. haematobium infection. Brain. 108 ( Pt 4):1023-38, 1985
- Queiroz LS et al: Massive spinal cord necrosis in schistosomiasis. Arch Neurol. 36(8): 517-9, 1979
- Norfray JF et al: Schistosomiasis of the spinal cord. Surg Neurol. 9(1): 68-71, 1978
- Siddorn JA: Schistosomiasis and anterior spinal artery occlusion. Am J Trop Med Hyg. 27(3): 532-4, 1978
- Lechtenberg R et al: Schistosomiasis of the spinal cord. Neurology. 27(1): 55-9, 1977
