Spinal cord schistosomiasis japonica: a report of 4 cases.

BACKGROUND: Neuroschistosomiasis is a severe presentation of schistosomal infection. Currently however, spinal cord schistosomiasis japonica is clinically rare, and very few cases are reported.
METHODS: The purpose of this study is to retrospectively analyze the diagnosis and treatment of 4 patients who presented with a lower cord syndrome of acute progression characterized by motor, sensory, and autonomic dysfunctions. The patients were examined by MRI, and the biochemical and immunologic changes of blood and CSF of the patients were also analyzed before surgery. Treatments including surgical resection and antischistosomal drugs followed by a histologic examination were used to confirm the diagnosis.
RESULTS: Spinal cord schistosomiasis japonica is a very rare disease. Magnetic resonance imaging can obtain precise position fixing, although it is hard to make preoperative qualitative determination. Postoperative follow-up assessment indicated that the symptoms of 4 patients had improved without further treatment.
CONCLUSIONS: The main clinical manifestations of spinal cord schistosomiasis japonica have some common features, and MRI is useful and important in diagnosing the disease. The most effective treatment for the disease that shows radiological evidence of spinal cord or conus compression and inefficacious expectant treatment by other methods is to excise it totally and apply antischistosomal drugs.