Guidelines for the diagnosis and treatment of schistosomal myeloradiculopathy

Revista da Sociedade Brasileira de Medicina Tropical

José Roberto Lambertucci²  Luciana Cristina Dos Santos Silva²  Ronaldo Santos Do Amaral¹ 

[1],Universidade Federal de Minas Gerais Faculdade de Medicina Clínica de Doenças Infecciosas e Parasitárias MG ,Brazil

关键词: Schistosomiasis;    Neuroschistosomiasis;    Myeloradiculopathy;    Steroids;    Praziquantel;    Esquistossomose;    Neuroesquistossomose;    Mielorradiculopatia;    Esteróides;    Praziquantel;   

DOI  :  10.1590/S0037-86822007000500016

来源: SciELO

【 摘 要 】

Schistosomal myeloradiculopathy is the most severe and disabling ectopic form of Schistosoma mansoni infection. The prevalence of SMR in centres in Brazil and Africa that specialise in attending patients with non traumatic myelopathy is around 5%. The initial signs and symptoms of the disease include lumbar and/or lower limb pain, paraparesis, urinary and intestinal dysfunctions, and impotence in men. The cerebrospinal fluid of SMR patients shows an increase in protein concentration and in the number of mononuclear cells in 90% of cases; eosinophils have been reported in 40%. The use of magnetic resonance imaging is particularly valuable in the diagnosis of Schistosomal myeloradiculopathy. The exclusion of other myelopathies and systemic diseases remains mandatory. Early diagnosis and treatment with steroids and schistosomicides provide a cure for most patients, whilst delayed treatment can result in irreversible physical disabilities or death. To improve awareness concerning Schistosomal myeloradiculopathy amongst public health professionals, and to facilitate the control of the disease, the Brazilian Ministry of Health has launched a program of education and control of this ectopic form of schistosomiasis. The present paper reviews current methods for the diagnosis of SMR and outlines protocols for treatment of the disease.

【 授权许可】

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