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以反复癫痫发作为表现的神经血吸虫病:一例报告。

Neuroschistosomiasis presenting as recurrent seizures: A case report.

作者信息

Bansal Anushree, Albano Joselv Eullaran, Jayakumar Dheeraj

机构信息

Department of Pediatrics, Davao Medical School Foundation, Medical Center, Davao City, Philippines.

Section of Neurosurgery, Southern Philippines Medical Center, Davao City, Philippines.

出版信息

Surg Neurol Int. 2025 Feb 14;16:51. doi: 10.25259/SNI_1115_2024. eCollection 2025.

Abstract

BACKGROUND

Cerebral pseudotumoral schistosomiasis is an uncommon and underreported condition, posing significant diagnostic challenges due to its ability to mimic other neurological conditions, especially in patients presenting with persistent seizures and imaging findings indicative of an infectious etiology.

CASE DESCRIPTION

We report the case of a 16-year-old male who presented with persistent headaches and recurrent seizures despite adherence to antiseizure medications. Neuroimaging findings suggested an infectious process but were inconclusive in differentiating between a tuberculoma and cerebral schistosomiasis. Given the differing therapeutic approaches required for these conditions, a definitive diagnosis was pursued through a brain tissue biopsy, which confirmed cerebral schistosomiasis. This diagnosis guided appropriate treatment, leading to clinical improvement.

CONCLUSION

This case highlights the critical role of biopsy in establishing a definitive diagnosis when imaging results are inconclusive and suggests the importance of exploring the use of adjunct diagnostic methods like magnetic resonance spectroscopy, hence decreasing or potentially eliminating the need for an open biopsy.

摘要

背景

脑假瘤型血吸虫病是一种罕见且报道不足的疾病,因其能够模仿其他神经系统疾病,给诊断带来了重大挑战,尤其是对于那些出现持续性癫痫发作且影像学检查结果提示感染性病因的患者。

病例描述

我们报告了一名16岁男性患者的病例,尽管坚持服用抗癫痫药物,但仍出现持续性头痛和反复癫痫发作。神经影像学检查结果提示存在感染性病变,但在鉴别结核瘤和脑血吸虫病方面尚无定论。鉴于这两种疾病所需的治疗方法不同,通过脑组织活检进行了明确诊断,结果证实为脑血吸虫病。这一诊断指导了恰当的治疗,使临床症状得到改善。

结论

本病例强调了在影像学结果不明确时活检对于明确诊断的关键作用,并提示探索使用磁共振波谱等辅助诊断方法的重要性,从而减少或可能消除开放性活检的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3063/11878708/d0d621afb91f/SNI-16-51-g001.jpg

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