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Spinal schistosomiasis: Cases in Egyptian population

BACKGROUND: Spinal cord involvement by schistosomiasis is considered to be rare. Clinical presentation of spinal schistosomiasis ranges from radicular pain to myelopathy causing flaccid paraplegia, bladder incontinence, and dysesthesia. We reported six cases with spinal schistosomiasis. METHODOLOGY:...

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Autores principales: Ashour, Ahmed M, Elserry, Tarek H, Nosser, Mohamed S, Fayed, Zeyad Y, Samir, Mohamed Wael, Fakher, Alaa, Ashour, Maamoun M, Salama, Mamdouh M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5934970/
https://www.ncbi.nlm.nih.gov/pubmed/29755242
http://dx.doi.org/10.4103/jcvjs.JCVJS_2_18
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author Ashour, Ahmed M
Elserry, Tarek H
Nosser, Mohamed S
Fayed, Zeyad Y
Samir, Mohamed Wael
Fakher, Alaa
Ashour, Maamoun M
Salama, Mamdouh M
author_facet Ashour, Ahmed M
Elserry, Tarek H
Nosser, Mohamed S
Fayed, Zeyad Y
Samir, Mohamed Wael
Fakher, Alaa
Ashour, Maamoun M
Salama, Mamdouh M
author_sort Ashour, Ahmed M
collection PubMed
description BACKGROUND: Spinal cord involvement by schistosomiasis is considered to be rare. Clinical presentation of spinal schistosomiasis ranges from radicular pain to myelopathy causing flaccid paraplegia, bladder incontinence, and dysesthesia. We reported six cases with spinal schistosomiasis. METHODOLOGY: We did a retrospective analysis of the records in our department from March 1995 to March 2015, and we found that six cases of proved spinal schistosomiasis were documented, with follow-up period more than a year, aiming to find an assumption for a guideline for this ambiguous issue. RESULTS: We found five cases from six were males and average age group was 26 years old (14–43). All had motor deficit (100%) which was variable, only two (33.33%) had dense weakness (G0) at time of presentation, three (50%) patients had sphincter disturbance also, and 50% of the patients presented with back pain as initial symptom. Only one of six patients had a positive history of the infestation. All patients went through surgical intervention, which was decompression laminectomy then biopsy or excision. Total excision was feasible only in two cases (33.33%), which had a well-defined lesion in imaging, while in others, lesion was ill defined and adherent, so biopsy was done. Steroids up to 2-month duration were used in all patients (100%) and praziquantel in repeated cycles after surgical excision or biopsy was used in all patients (100%). CONCLUSION: History of travelling to endemic areas should raise the suspicion which may be the cornerstone of diagnosis, particularly in conus/epiconus intramedullary lesions. Surgical excision and spinal canal decompression are the best line of treatment in cases of schistosomiasis even if this excision was not total but to confirm and exclude other forms of pathology. Steroids and oral Praziquantel in repeated cycles are the best medication regimen in case of myelitis and in postoperative treatment.
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spelling pubmed-59349702018-05-11 Spinal schistosomiasis: Cases in Egyptian population Ashour, Ahmed M Elserry, Tarek H Nosser, Mohamed S Fayed, Zeyad Y Samir, Mohamed Wael Fakher, Alaa Ashour, Maamoun M Salama, Mamdouh M J Craniovertebr Junction Spine Case Report BACKGROUND: Spinal cord involvement by schistosomiasis is considered to be rare. Clinical presentation of spinal schistosomiasis ranges from radicular pain to myelopathy causing flaccid paraplegia, bladder incontinence, and dysesthesia. We reported six cases with spinal schistosomiasis. METHODOLOGY: We did a retrospective analysis of the records in our department from March 1995 to March 2015, and we found that six cases of proved spinal schistosomiasis were documented, with follow-up period more than a year, aiming to find an assumption for a guideline for this ambiguous issue. RESULTS: We found five cases from six were males and average age group was 26 years old (14–43). All had motor deficit (100%) which was variable, only two (33.33%) had dense weakness (G0) at time of presentation, three (50%) patients had sphincter disturbance also, and 50% of the patients presented with back pain as initial symptom. Only one of six patients had a positive history of the infestation. All patients went through surgical intervention, which was decompression laminectomy then biopsy or excision. Total excision was feasible only in two cases (33.33%), which had a well-defined lesion in imaging, while in others, lesion was ill defined and adherent, so biopsy was done. Steroids up to 2-month duration were used in all patients (100%) and praziquantel in repeated cycles after surgical excision or biopsy was used in all patients (100%). CONCLUSION: History of travelling to endemic areas should raise the suspicion which may be the cornerstone of diagnosis, particularly in conus/epiconus intramedullary lesions. Surgical excision and spinal canal decompression are the best line of treatment in cases of schistosomiasis even if this excision was not total but to confirm and exclude other forms of pathology. Steroids and oral Praziquantel in repeated cycles are the best medication regimen in case of myelitis and in postoperative treatment. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5934970/ /pubmed/29755242 http://dx.doi.org/10.4103/jcvjs.JCVJS_2_18 Text en Copyright: © 2018 Journal of Craniovertebral Junction and Spine http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Ashour, Ahmed M
Elserry, Tarek H
Nosser, Mohamed S
Fayed, Zeyad Y
Samir, Mohamed Wael
Fakher, Alaa
Ashour, Maamoun M
Salama, Mamdouh M
Spinal schistosomiasis: Cases in Egyptian population
title Spinal schistosomiasis: Cases in Egyptian population
title_full Spinal schistosomiasis: Cases in Egyptian population
title_fullStr Spinal schistosomiasis: Cases in Egyptian population
title_full_unstemmed Spinal schistosomiasis: Cases in Egyptian population
title_short Spinal schistosomiasis: Cases in Egyptian population
title_sort spinal schistosomiasis: cases in egyptian population
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5934970/
https://www.ncbi.nlm.nih.gov/pubmed/29755242
http://dx.doi.org/10.4103/jcvjs.JCVJS_2_18
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