Spinal cysticercosis: a rare cause of myelopathy

BMC Neurology

Tie Liu¹  Wenqing Jia¹  Yulun Xu¹  Jun Yang²  Jingcheng Xie²  Tao Yu²  Chenlong Yang³  Jian Wu⁴ 

[1] Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Department of Neurosurgery, Peking University Third Hospital, Haidian District, Beijing, China;Department of Neurosurgery, Peking University Third Hospital, Haidian District, Beijing, China;North America Medical Education Foundation, Union, CA, USA;Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA;

关键词: Cysticercosis;    Parasitic infection;    Myelopathy;    Neurocysticercosis;    Taenia solium;   

DOI  :  10.1186/s12883-022-02589-2

来源: Springer

【 摘 要 】

BackgroundNeurocysticercosis is a neuroinfectious disease caused by the larval stage of the tapeworm Taenia solium. Isolated spinal cysticercosis is rare, with limited cases having been reported in the literature. This entity poses great diagnostic and therapeutic challenges.MethodsThis retrospective study included seven patients pathologically diagnosed with spinal cysticercosis. The clinical manifestations, radiological features on magnetic resonance imaging (MRI), treatment, and outcomes were analyzed.ResultsThis case series consisted of four male and three female patients, with an average age of 34.9 ± 10.9 years. Clinically, six patients manifested with localization-related myelopathy. There were four solid lesions, one cystic-solid lesion, and three cystic lesions. The solid and cystic-solid lesions showed characteristic MRI features: 1) within the lesion, there was a mural nodule with isointensity on T1WI and iso- to hyperintensity on T2WI; 2) the signals at the periphery of the mural nodule were variable, ranging from hypointense to hyperintense on T2WI; and 3) ring-like or cyst wall enhancement could be present, and dot-like enhancement could be noted in the mural nodule. Complete resection of the responsible lesion was achieved in all patients, and oral albendazole was administered in a patient with one more suspected homologous lesion. After a mean follow-up period of 56.7 ± 35.1 months, the patient’s symptoms mostly regressed.ConclusionSpinal cysticercosis is an extremely rare cause of myelopathy. Characteristic MRI features can facilitate preoperative diagnosis. Clinicians should be aware of this entity, and it should be included in the differential diagnosis of myelopathy.

【 授权许可】

CC BY