Spinal Intramedullary Cysticercosis: A Summary of Three Cases in Thailand.

Sir,

Cysticercosis is an important cestode infection. The infection is due to the ingestion of food contaminated with parasite egg [Figure 1]. The formation of parasitic cyst [Figure 2] inside the body is the main clinical problem of cysticercosis [Figure 2]. The infection can be at any organ systems including the neurological system. The specific neurological infection of cysticercosis is called neurocysticercosis. Neurocysticercosis is a common problem seen worldwide. The problem is considered an important tropical neurological infection. Most patients with neurocysticercosis have the pathological at brains. The patients might have no symptom or present with unexplained neurological problems such as seizure. Apart from brain, neurocysticercosis is detectable at the spinal cord. The extramedullary or intramedullary neurocysticercosis can be seen in clinical practice. In medicine, spinal intramedullary cysticercosis is an extremely rare condition. Less than 100 cases are available on the international publications.

Figure 1

Taenia egg that can contaminate in food and further causes cysticercosis

Figure 2

Cysticercosis cyst in flesh

Here, the authors summarize the data on published cases from Thailand; a tropical endemic country of cysticercosis. Based on the literature search on international and local databases (PubMed, Scopus, and Thai Index Medicus), there are only 3 publications on spinal intramedullary cysticercosis from Thailand.[123] There are 2 female and 1 male. All patients present with spinal cord compression and one case had additional bilateral sensory neural hearing loss and hydrocephalus. The lesions can be seen at any spinal cord levels, and multi-level involvement is common (cervical level 1 case, thoracic level 3 cases, and lumbar level 3 cases). Syringomyelia is an additional spinal cord problem in 1 case. All patients got surgical treatment, and only 2 from 3 cases have a complete recovery. The case without complete recovery ends up with death due to status epilepticus and septic shock.

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