Spinal cysticercosis: A case report

Spinal cysticercosis is a rare and severe cysticercosis complication. The pathology is from the inflammatory reaction and granuloma formation around the eggs, which cause focal neurological deficits. Because of the rarity of this condition, diagnosis may be delayed and confused with other myelopathies such as neoplasms or myelitis. We report a 42-year-old woman with low back pain and paraplegia. Magnetic resonance imaging showed a lesion in the spinal canal at the level of L4/L5 that was toward the diagnosis of myelitis. The patient underwent an open biopsy, and the result was granulomatosis caused by cysticercosis. The patient was then given an anticysticercosis medication and gradually recovered.

Spinal nerve root sleeve cysticercosis: a case report and review of the literature

BACKGROUND

Neurocysticercosis is a parasitic infection of the central nervous system by tapeworm larvae. Spinal cysticercosis is thought to be relatively rare, and spinal nerve root sleeve cysticercosis have not been reported previously.

CASE PRESENTATION

A 46-year-old Chinese Han female patient presented with low back pain and radicular pain of the right lower limb. The visual analog scale was 6. Magnetic resonance imaging showed a subarachnoid cyst at the S1 level, with a slight enhanced rim. The patient underwent surgical treatment. During surgery, we found the cyst located mainly in the subarachnoid space and partly in a sacral nerve root sleeve. Cysticercosis was also confirmed by postoperative pathological examination. Postoperative drug therapy was performed after cysticercosis was confirmed. Postoperatively, the patient was treated with oral albendazole (15 mg/kg) for 1 month. Only mild sensory impairment was left when she was discharged. After 3 years of follow-up, the visual analog scale reduced from 6 to 2, and the patient's sensory function completely recovered. Magnetic resonance imaging showed no recurrence of cysticercosis.

CONCLUSION

Subarachnoid cysticercosis may extend to nerve root sleeve causing back pain and radiculopathy, which may present with similar magnetic resonance imaging manifestations to Tarlov cysts. Hence, spinal subarachnoid cysticercosis should be considered as an important differential diagnosis of arachnoid cyst and sacral Tarlov cyst. Combined treatment with surgical removal and drug therapy is effective to manage spinal subarachnoid cysticercosis.

A Rare Case of Cysticercosis Involving the Whole Spinal Canal

BACKGROUND

Cysticercosis is the commonest parasitic disease to affect the central nervous system (CNS). However, cysticercosis affecting the spine is extremely rare. We reported a rare case of cysticercosis involving the whole spinal canal in China.

CASE PRESENTATION

A rare case of cysticercosis involving the entire spinal cord, in a 52-year-old Chinese man, was detected in 2021. Epidemiological investigation, clinical and etiological examination was performed.

CONCLUSION

Since spinal cysticercosis is a rare but potentially life-threatening disease, clinicians should always consider the differential diagnosis of space-occupying lesions.

Spinal cord compression by multiple cysticercosis

Background:

Neurocysticercosis (NCC) is the most common parasitic infection involving the central nervous system in endemic areas. Notably, spinal involvement occurs in only 0.7%–3% of patients.

Case Description:

A 58-year-old female presented with progressive spinal cord compression attributed to multiple cystic intradural extramedullary thoracic lesions. She underwent laminectomy at two separate thoracic levels; this involved excision of the upper T4–T6, and just exploration of the lower T9–T11 lesions. One year postoperatively, she exhibited a residual paraparesis.

Conclusion:

Spinal NCC must be considered among the differential diagnostic considerations for patients presenting with spinal intramedullary or subarachnoid/extramedullary cystic lesions. Although they are typically found in endemic regions, those who have traveled to these locations are also susceptible. Even though it is considered a benign condition, spinal NCC may cause permanent and irreversible neurological damage. Public health policies should, therefore, be developed to help control the spread and transmission of NCC.

Spinal Taenia solium cysticercosis in Mexican and Indian patients: a comparison of 30-year experience in two neurological referral centers and review of literature

OBJECTIVE

To present a retrospective study from patients with spinal cysticercosis (SC), diagnosed within the last 30 years in Mexican and Indian neurological referral centers.

METHODS

This is a retrospective and comparative study of the clinical and radiological profile between Mexican and Indian patients with spinal neurocysticercosis during a 30-year period and a review of the literature during the same period.

RESULTS

Twenty-seven SC patients were included: 19 from Mexico and 8 from India. SC presented predominantly with motor symptoms (21/27 patients): paraparesis and paraplegia were the most common signs; one-third of patients presented sphincter dysfunction. Imaging studies showed that parasites in vesicular stage were more frequent in patients from Mexico, while degenerative stages predominated in India. Association of subarachnoid cysticerci and hydrocephalus was observed only in Mexican patients.

CONCLUSIONS

Despite the limitations of this study, the collected information supports the existence of differences in the clinical and radiological traits of SC patients between Asian and Latin-American hospitals. The possible biological factors that may underlie these differences are discussed.

Herniated lumbar disc combined with spinal intradural extramedullary cysticercosis

Spinal cysticercosis is a very uncommon manifestation of neurocysticercosis which is caused by the larvae of Taenia solium. However, it can develop as a primary infection through blood stream or direct larval migration. It can result in high recurrence and severe neurologic morbidity if not treated appropriately. We report the case of a 43-year-old woman who presented with severe lower back pain and left leg radiating pain in recent 2 weeks. Magnetic resonance image (MRI) of lumbar spine demonstrated extruded disc at the L5-S1 level combined with intradural extramedullary cystic lesion. We performed the open lumbar microdiscectomy (OLM) at L5-S1 on the left with total excision of cystic mass. After surgery, the patient showed an improvement of previous symptoms. Diagnosis was confirmed by histopathological examination as intradural extramedullary cysticercosis. We discuss clinical features, diagnostic screening, and treatment options of spinal cysticercosis.