Parasitoses of the human central nervous system

Abstract Cerebral involvement in parasitoses is an important clinical manifestation of most of the human parasitoses. Parasites that have been described to affect the central nervous system (CNS), either as the dominant or as a collateral feature, include cestodes (Taenia solium (neurocysticerciasis), Echinococcus granulosus (cerebral cystic echinococcosis), E. multilocularis (cerebral alveolar echinococcosis), Spirometra mansoni (neurosparganosis)), nematodes (Toxocara canis and T. cati (neurotoxocariasis), Trichinella spiralis (neurotrichinelliasis), Angiostrongylus cantonensis and A. costaricensis (neuroangiostrongyliasis), Gnathostoma spinigerum (gnathostomiasis)), trematodes (Schistosoma mansoni (cerebral bilharziosis), Paragonimus westermani (neuroparagonimiasis)), or protozoa (Toxoplasma gondii (neurotoxoplasmosis), Acanthamoeba spp. or Balamuthia mandrillaris (granulomatous amoebic encephalitis), Naegleria (primary amoebic meningo-encephalitis), Entamoeba histolytica (brain abscess), Plasmodium falciparum (cerebral malaria), Trypanosoma brucei gambiense/rhodesiense (sleeping sickness) or Trypanosoma cruzi (cerebral Chagas disease)). Adults or larvae of helminths or protozoa enter the CNS and cause meningitis, encephalitis, ventriculitis, myelitis, ischaemic stroke, bleeding, venous thrombosis or cerebral abscess, clinically manifesting as headache, epilepsy, weakness, cognitive decline, impaired consciousness, confusion, coma or focal neurological deficits. Diagnosis of cerebral parasitoses is dependent on the causative agent. Available diagnostic tools include clinical presentation, blood tests (eosinophilia, plasmodia in blood smear, antibodies against the parasite), cerebrospinal fluid (CSF) investigations, imaging findings and occasionally cerebral biopsy. Treatment relies on drugs and sometimes surgery. Outcome of cerebral parasitoses is highly variable, depending on the effect of drugs, whether they are self-limiting (e.g. Angiostrongylus costaricensis) or whether they remain undetected or asymptomatic, like 25% of neurocysticerciasis cases.

[1]  L. Toussaint,et al.  What is the utility of postoperative antihelminthic therapy after resection for intraventricular neurocysticercosis? , 2013, World neurosurgery.

[2]  Shukla Das,et al.  Correlation between the clinico radiological heterogeneity and the immune-inflammatory profiles in pediatric patients with neurocysticercosis from a tertiary referral centre. , 2012, Journal of tropical pediatrics.

[3]  B. Sharma,et al.  Intraventricular neurocysticercosis: a review of current status and management issues , 2012, British journal of neurosurgery.

[4]  O. H. Brutto,et al.  Changing pattern of neurocysticercosis in an urban endemic center (Guayaquil, Ecuador) , 2012, Journal of Neurological Sciences.

[5]  A. Craig,et al.  Cerebral malaria pathogenesis: revisiting parasite and host contributions. , 2012, Future microbiology.

[6]  H. Jung-Cook.  Pharmacokinetic variability of anthelmintics: implications for the treatment of neurocysticercosis , 2012, Expert review of clinical pharmacology.

[7]  A. Arauz,et al.  Cerebrovascular Complications of Neurocysticercosis , 2012, The neurologist.

[8]  J. Stockman.  Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial , 2012 .

[9]  K. Sawanyawisuth,et al.  A comparative study of neuroimaging features between human neuro-gnathostomiasis and angiostrongyliasis , 2012, Neurological Sciences.

[10]  Baohui Liu,et al.  Clinical and Imaging Characteristics of Cerebral Schistosomiasis , 2011, Cell Biochemistry and Biophysics.

[11]  M. Castillo,et al.  Parasitic diseases of the central nervous system. , 2011, Neuroimaging clinics of North America.

[12]  S. Garg,et al.  Clinical profiles of 13 children with Plasmodium vivax cerebral malaria , 2011, Annals of tropical paediatrics.

[13]  T. Costa-Silva,et al.  Immunodiagnosis in cerebrospinal fluid of cerebral toxoplasmosis and HIV-infected patients using Toxoplasma gondii excreted/secreted antigens. , 2011, Diagnostic microbiology and infectious disease.

[14]  R. Bazan,et al.  Aneurysm and Neurocysticercosis: Casual or Causal Relationship? Case Report and Review of the Literature , 2011, Case Reports in Medicine.

[15]  Q. Zhao,et al.  Efficacy of praziquantel and artemisinin derivatives for the treatment and prevention of human schistosomiasis: a systematic review and meta-analysis , 2011, Parasites & Vectors.

[16]  M. Py.  Neurologic Manifestations of Chagas Disease , 2011, Current neurology and neuroscience reports.

[17]  T. Ferrari,et al.  Neuroschistosomiasis: clinical symptoms and pathogenesis , 2011, The Lancet Neurology.

[18]  J. Lambertucci,et al.  Schistosoma mansoni encephalomyelitis. , 2011, Archives of Neurology.

[19]  T. Miura,et al.  Cerebral Schistosomiasis Due to Schistosoma haematobium Confirmed by PCR Analysis of Brain Specimen , 2011, Journal of Clinical Microbiology.

[20]  I. Gojo,et al.  Granulomatous amebic encephalitis: an under‐recognized cause of infectious mortality after hematopoietic stem cell transplantation , 2011, Transplant infectious disease : an official journal of the Transplantation Society.

[21]  Yiping Li,et al.  Spinal Intramedullary Cysticercosis: A Case Report and Literature Review , 2011, International Journal of Medical Sciences.

[22]  S. Qian,et al.  Diagnosis and stereotactic aspiration treatment of cerebral sparganosis: summary of 11 cases. , 2011, Journal of neurosurgery.

[23]  R. Gilman,et al.  Pharmacokinetics of combined treatment with praziquantel and albendazole in neurocysticercosis. , 2011, British journal of clinical pharmacology.

[24]  I. Marincu,et al.  Trichinellosis, another helminthiasis affecting the central nervous system. , 2011, Parasitology international.

[25]  Wenjiang J. Fu,et al.  The Neuropathology of Fatal Cerebral Malaria in Malawian Children , 2011, The American journal of pathology.

[26]  M. Phillips,et al.  State of the art in African trypanosome drug discovery. , 2011, Current topics in medicinal chemistry.

[27]  P. Teunis,et al.  Human beings are highly susceptible to low doses of Trichinella spp. , 2011, Epidemiology and Infection.

[28]  R. Mahajan,et al.  Case of sparganosis: a diagnostic dilemma. , 2011, Indian journal of medical microbiology.

[29]  A. Mahadevan,et al.  Diagnosis of cerebral toxoplasmosis , 2011, Annals of Indian Academy of Neurology.

[30]  Susan Lewallen,et al.  Redefining cerebral malaria by including malaria retinopathy. , 2011, Future microbiology.

[31]  P. Di Carlo,et al.  Cystic hydatidosis: a rare case of spine localization. , 2011, ˜Le œInfezioni in medicina.

[32]  S. Lewin,et al.  Balamuthia mandrillaris brain abscess successfully treated with complete surgical excision and prolonged combination antimicrobial therapy. , 2011, Journal of neurosurgery.

[33]  D. Belen,et al.  Alveolar hydatid cyst mimicking cerebellar metastatic tumor , 2011, Surgical neurology international.

[34]  V. Prendki,et al.  The pathogenesis of Plasmodium falciparum malaria in humans: insights from splenic physiology. , 2011, Blood.

[35]  V. Patil,et al.  Successful treatment of cerebral toxoplasmosis with cotrimoxazole , 2011, Indian journal of sexually transmitted diseases and AIDS.

[36]  A. E. Podoprigora,et al.  [Multiple echinococcosis of brain, heart and kidneys]. , 2011, Voprosy neirokhirurgii imeni N N Burdenko.

[37]  N. Wani,et al.  Computed tomography findings in cerebral hydatid disease. , 2011, Turkish neurosurgery.

[38]  P. P. Christo,et al.  Granulomatous amoebic meningoencephalitis in an immunocompetent patient. , 2010, Archives of neurology.

[39]  G. Visvesvara.  Amebic meningoencephalitides and keratitis: challenges in diagnosis and treatment* , 2010, Current opinion in infectious diseases.

[40]  Nora Dackiewicz,et al.  [Chagas' disease as a cause of cerebral mass in a patient with lymphoblastic leukemia in remission]. , 2010, Archivos argentinos de pediatria.

[41]  J. Walochnik,et al.  Granulomatous Amebic Encephalitis in a Child with Acute Lymphoblastic Leukemia Successfully Treated with Multimodal Antimicrobial Therapy and Hyperbaric Oxygen , 2010, Journal of Clinical Microbiology.

[42]  Kamolrat Silamut,et al.  Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial , 2010, The Lancet.

[43]  K. Marsh,et al.  Cerebral Malaria: Mechanisms of Brain Injury and Strategies for Improved Neurocognitive Outcome , 2010, Pediatric Research.

[44]  C. John,et al.  Adjunctive therapy for cerebral malaria and other severe forms of Plasmodium falciparum malaria , 2010, Expert review of anti-infective therapy.

[45]  S. Kim,et al.  MRI findings of spinal visceral larva migrans of Toxocara canis. , 2010, European journal of radiology.

[46]  M. Barrett,et al.  Diamidines for human African trypanosomiasis. , 2010, Current opinion in investigational drugs.

[47]  M. Aras,et al.  A medically treated multiple cerebral hydatid cyst disease. , 2010, Journal of Neurosurgical Sciences.

[48]  T. Orduna,et al.  Neurological manifestations of Chagas' disease , 2010, Neurological research.

[49]  C. Gutiérrez,et al.  Human toxocariasis: a seroepidemiological survey in the Amazonian city of Yurimaguas, Peru. , 2010, Revista do Instituto de Medicina Tropical de Sao Paulo.

[50]  J. Utzinger,et al.  Helminth infections of the central nervous system occurring in Southeast Asia and the Far East. , 2010, Advances in parasitology.

[51]  J. Rodgers.  Trypanosomiasis and the brain , 2009, Parasitology.

[52]  A. Bartuliene,et al.  Trichinellosis outbreak in Lithuania, Ukmerge region, June 2009. , 2009, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[53]  Yu-xian Huang,et al.  [Clinical analysis of 78 cases of parasitic encephalopathy]. , 2009, Zhongguo ji sheng chong xue yu ji sheng chong bing za zhi = Chinese journal of parasitology & parasitic diseases.

[54]  P. Singhi,et al.  Neurocysticercosis in children , 2009, Indian journal of pediatrics.

[55]  A. Meléis,et al.  Cerebral toxoplasmosis: case review and description of a new imaging sign. , 2009, Clinical radiology.

[56]  C. You,et al.  Surgical treatment options for cerebral alveolar echinococcosis: experience in six patients. , 2009, Neurology India.

[57]  K. Sawanyawisuth,et al.  Sequential imaging studies of cerebral gnathostomiasis with subdural hemorrhage as its complication. , 2009, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[58]  M. Schroeter,et al.  Cognitive dysfunction, urinary retention, and a lesion in the thalamus—Beware of possible toxocariasis of the central nervous system , 2008, Clinical Neurology and Neurosurgery.

[59]  Hai-feng Li,et al.  [Cerebral Sparganosis mansoni: a case report]. , 2008, Zhonghua er ke za zhi = Chinese journal of pediatrics.

[60]  W. Müllges,et al.  Brain and lung metastasis of alveolar echinococcosis in a refugee from a hyperendemic area. , 2008, Journal of medical microbiology.

[61]  K. Su,et al.  Blood–brain barrier impairment with enhanced SP, NK‐1R, GFAP and Claudin‐5 expressions in experimental cerebral toxocariasis , 2008, Parasite immunology.

[62]  Hsin-Yun Sun,et al.  Clinical presentation and outcome of toxoplasmic encephalitis in patients with human immunodeficiency virus type 1 infection. , 2008, Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi.

[63]  S. Mayor.  WHO report shows progress in efforts to reduce malaria incidence , 2008, BMJ : British Medical Journal.

[64]  S. Jongwutiwes,et al.  Spinal gnathostomiasis resembling an intrinsic cord tumor/myelitis in a 4-year-old boy. , 2008, The Southeast Asian journal of tropical medicine and public health.

[65]  H. Feng,et al.  Acute cerebral paragonimiasis presenting as hemorrhagic stroke in a child. , 2008, Pediatric neurology.

[66]  P. Kennedy.  The continuing problem of human African trypanosomiasis (sleeping sickness) , 2008, Annals of neurology.

[67]  B. Bouteille,et al.  MARQUEURS DU STADE NEUROLOGIQUE DE LA TRYPANOSOMOSE HUMAINE AFRICAINE : ACTUALITÉS ET PERSPECTIVES , 2008 .

[68]  Q. Ma,et al.  Magnetic resonance imaging of eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis following eating freshwater snails. , 2008, Chinese medical journal.

[69]  C. Apichartpiyakul,et al.  Randomized Controlled Trial of Pyrimethamine Plus Sulfadiazine Versus Trimethoprim Plus Sulfamethoxazole for Treatment of Toxoplasmic Encephalitis in AIDS Patients , 2008, Journal of the International Association of Physicians in AIDS Care.

[70]  S. Bisser,et al.  [Criteria for diagnosis of the neurological stage of human African trypanosomiasis: update and perspectives]. , 2008, Medecine tropicale : revue du Corps de sante colonial.

[71]  C. Dye,et al.  World Malaria Report, 2008. , 2008 .

[72]  M. Barrett,et al.  Human African trypanosomiasis: pharmacological re‐engagement with a neglected disease , 2007, British journal of pharmacology.

[73]  A. Brandis,et al.  Cerebral Sparganosis Presenting as Grand Mal Epilepsy , 2007, Journal of the Royal Army Medical Corps.

[74]  Z. Diao,et al.  [Clinical observation on 25 cases of severe angiostrongyliasis cantonensis]. , 2007, Zhongguo ji sheng chong xue yu ji sheng chong bing za zhi = Chinese journal of parasitology & parasitic diseases.

[75]  H. Jäger,et al.  Human African trypanosomiasis: diagnosis, relapse and survival after severe melarsoprol-induced encephalopathy. , 2007, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[76]  T. Garate,et al.  Outbreak of trichinellosis in Spain and Sweden due to consumption of wild boar meat contaminated with Trichinella britovi. , 2007, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[77]  S. Pradhan,et al.  Toxoplasma meningoencephalitis in HIV-seronegative patients: clinical patterns, imaging features and treatment outcome. , 2007, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[78]  N. Khandelwal,et al.  Amebic meningoencephalitis: spectrum of imaging findings. , 2006, AJNR. American journal of neuroradiology.

[79]  H. Jung-Cook,et al.  Evaluation of the efficacy of albendazole sulphoxide and praziquantel in combination on Taenia crassiceps cysts: in vitro studies. , 2006, The Journal of antimicrobial chemotherapy.

[80]  K. Oguz,et al.  Cerebral alveolar echinoccosis mimicking primary brain tumor. , 2006, AJNR. American journal of neuroradiology.

[81]  O. Takayanagui,et al.  Clinical aspects of neurocysticercosis. , 2006, Parasitology international.

[82]  F. Chochon,et al.  Toxocara canis meningomyelitis , 2005, Journal of Neurology.

[83]  Arjen Dondorp,et al.  Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial , 2005, The Lancet.

[84]  M. Castillo,et al.  Chagas' disease involving the brain and spinal cord: MRI findings. , 2005, AJR. American journal of roentgenology.

[85]  P. Sithinamsuwan,et al.  Gnathostomiasis — Neuroimaging of Larval Migration , 2005 .

[86]  N. Erdoğan,et al.  Diffusion‐weighted and conventional MR imaging in neurotrichinosis , 2005, Acta radiologica.

[87]  B. Neville,et al.  Persistent neurocognitive impairments associated with severe falciparum malaria in Kenyan children , 2005, Journal of Neurology, Neurosurgery & Psychiatry.

[88]  M. Prabhakar,et al.  Spinal Hydatid Disease: A Case Series , 2005, The journal of spinal cord medicine.

[89]  Weltgesundheitsorganisation.  World malaria report , 2005 .

[90]  P. Sithinamsuwan,et al.  Images in clinical medicine. Gnathostomiasis - neuroimaging of larval migration. , 2005, The New England journal of medicine.

[91]  Rosita Cheng-Ng,et al.  Prevalencia de infección por Toxocara en pre-escolares de una comunidad educativa de El Moján, estado Zulia, Venezuela. Resultados preliminares. , 2004 .

[92]  K. Sawanyawisuth,et al.  MR imaging findings in cerebrospinal gnathostomiasis. , 2004, AJNR. American journal of neuroradiology.

[93]  J. Estévez,et al.  [Prevalence of infection by Toxocara in schoolchildren in the community of El Moján, Zulia state, Venezuela]. , 2004, Investigacion clinica.

[94]  Young-Ha Lee,et al.  Chronic cerebral paragonimiasis combined with aneurysmal subarachnoid hemorrhage. , 2003, The American journal of tropical medicine and hygiene.

[95]  A. Seguro,et al.  Eosinophilic meningoencephalitis due to Toxocara canis: case report and review of the literature. , 2003, The American journal of tropical medicine and hygiene.

[96]  D. Chatha,et al.  MR imaging findings in African trypansomiasis. , 2003, AJNR. American journal of neuroradiology.

[97]  Karlsruhe,et al.  Cerebral Gnathostomiasis as a Cause of an Extended Intracranial Bleeding , 2003, Klinische Padiatrie.

[98]  Y. Nawa,et al.  A clinical study of eosinophilic meningoencephalitis caused by angiostrongyliasis. , 2002, Chinese medical journal.

[99]  J. Healy.  Balamuthia amebic encephalitis: radiographic and pathologic findings. , 2002, AJNR. American journal of neuroradiology.

[100]  M. Barrett,et al.  Chemotherapy of human African trypanosomiasis. , 2002, Current pharmaceutical design.

[101]  Yeong‐In Kim,et al.  Posterior Cerebral Artery Infarction Caused by Cerebral Sparganosis-Induced Vasculitis , 2001, European Neurology.

[102]  G. Kaw,et al.  Clinics in diagnostic imaging (58). Chronic cerebral paragonimiasis. , 2001, Singapore medical journal.

[103]  Newton Crjc..  NEUROLOGICAL ASPECTS OF TROPICAL DISEASE: Cerebral malaria , 2000 .

[104]  T. Tali,et al.  A viable residual spinal hydatid cyst cured with albendazole. Case report. , 2000, Journal of Neurosurgery.

[105]  G. Polo,et al.  [Evidence of cerebral involvement in the chronic stage of Chagas disease obtained using the P300 potential and quantified electroencephalography]. , 2000, Arquivos de neuro-psiquiatria.

[106]  M. Tunaci,et al.  MRI of cerebral alveolar echinococcosis , 1999, Neuroradiology.

[107]  F. Piedimonte,et al.  Cerebral tumor‐like American trypanosomiasis in acquired immunodeficiency syndrome , 1999, Annals of neurology.

[108]  B. Milošević,et al.  [Neurologic manifestations in trichinosis]. , 1998, Srpski arhiv za celokupno lekarstvo.

[109]  M. Han,et al.  Invited. MRI of CNS parasitic diseases , 1998 .

[110]  M. Han,et al.  MRI of CNS parasitic diseases. , 1998, Journal of magnetic resonance imaging : JMRI.

[111]  T. Hung,et al.  Current views on geographic distribution and modes of infection of neurohelminthic diseases , 1997, Journal of the Neurological Sciences.

[112]  M. Buysschaert,et al.  MRI of cervical cord lesions and their resolution in Toxocara canis myelopathy , 1996, Neuroradiology.

[113]  A. Buguet,et al.  Electroencephalographic and polygraphic features of 24-hour recordings in sleeping sickness and healthy African subjects. , 1996, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[114]  T. Uozumi,et al.  Cerebral Sparganosis Mansoni , 1995 .

[115]  W. Peh,et al.  Clinics in diagnostic imaging. , 1995, Singapore medical journal.

[116]  D. Stoltze,et al.  [High-grade transverse syndrome caused by echinococcus cysts]. , 1995, Der Nervenarzt.

[117]  N. Haddad,et al.  [Trichinosis and cerebral sinocavernous thrombosis]. , 1994, Revue neurologique (Paris).

[118]  M. Mojon.  [Human angiostrongyliasis caused by Angiostrongylus costaricensis]. , 1994, Bulletin de l'Academie nationale de medecine.

[119]  M. Han,et al.  Cerebral paragonimiasis in early active stage: CT and MR features. , 1994, AJR. American journal of roentgenology.

[120]  A. Buguet,et al.  Sleep-wake cycle in human African trypanosomiasis. , 1993, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[121]  H. Hadidi,et al.  MRI in cerebral toxocaral disease. , 1991, Journal of neurology, neurosurgery, and psychiatry.

[122]  M. Molyneux,et al.  Clinical features and prognostic indicators in paediatric cerebral malaria: a study of 131 comatose Malawian children. , 1989, The Quarterly journal of medicine.

[123]  T. Chirachariyavej,et al.  Neurological manifestations of gnathostomiasis , 1977, Journal of the Neurological Sciences.

[124]  O. Grados,et al.  Mature Paragonimus amazonicus first found from a water opossum in Peru. , 1974, Journal of Parasitology.

[125]  S. Oh,et al.  Paragonimus meningitis. , 1968, Journal of the neurological sciences.

[126]  N. Khan..  Cerebral Malaria , 1951, The Indian medical gazette.