Prevalence of urodynamic changes with risk for upper urinary tract damage in neuroschistosomiasis patients

Abstract INTRODUCTION: This study aimed to identify the prevalence of urodynamic changes with an associated risk of developing upper urinary tract damage in neuroschistosomiasis patients. METHODS: A prospective study was conducted, wherein68 patients were admitted for analysis of urodynamics, urea and creatinine levels, and uroculture. RESULTS: Blood test results did not indicate kidney failure. There were cases of asymptomatic bacteriuria. Common symptoms were frequent nocturia and detrusor overactivity. Results of low compliance and low cystometric capacity were both statistically significant (p = 0.001 and p = 0.002, respectively). CONCLUSIONS: A high prevalence of negative urodynamic changes were found in neuroschistosomiasis patients.

Simultaneous occurrence of brain tumor and myeloradiculopathy in schistosomiasis mansoni: case report / Ocorrência simultânea de tumor cerebral e mielorradiculopatia na esquistossomose mansoni: relato de caso

Simultaneous occurrence of brain tumor and myeloradiculopathy in cases of Manson's schistosomiasis have only rarely been described. We report the case of a 38-year-old man who developed seizures during a trip to Puerto Rico and in whom a brain tumor was diagnosed by magnetic resonance imaging: brain biopsy revealed the diagnosis of schistosomiasis. He was transferred to a hospital in the United States and, during hospitalization, he developed sudden paraplegia. The diagnosis of myeloradiculopathy was confirmed at that time. He was administered praziquantel and steroids. The brain tumor disappeared, but the patient was left with paraplegia and fecal and urinary dysfunction. He has now been followed up in Brazil for one year, and his clinical state, imaging examinations and laboratory tests are presented here.

Tem sido descrita, raramente, na esquistossomose mansônica, a ocorrência simultânea de tumor cerebral e mielorradiculopatia. Relatamos aqui o caso de um homem de 38 anos que desenvolveu convulsões, durante viagem a Porto Rico, e um tumor cerebral foi diagnosticado à ressonância magnética: a biópsia do cérebro revelou o diagnóstico de esquistossomose. Ele foi transferido para hospital na América do Norte e durante a hospitalização desenvolveu súbita paraplegia. O diagnóstico de mielorradiculopatia foi confirmado na ocasião. Ele recebeu praziquantel e esteróides. O tumor cerebral desapareceu, mas o paciente permaneceu com paraplegia, disfunção urinária e fecal. Ele tem sido acompanhado no Brasil no último ano e o seu estado clínico, os métodos de imagem e os exames de laboratório são apresentados aqui.

Aspectos eletromiográficos preditores da evolução motora de pacientes com neuroesquistossomose / Electromyografic patterns predictive of motor evolution in neuroschistosomiasis

A neuroesquistossomose na forma mielorradicular é freqüentemente observada nos pacientes que residem no Nordeste do Brasil. Apesar disso, a evolução dos seus distúrbios neurológicos e padrões eletromiográficos são pouco estudados nesse grupo de pacientes. O objetivo deste estudo foi descrever e comparar a evolução motora com as anormalidades eletromiográficas de pacientes com neuroesquistossomose. Foram realizadas eletromiografias dos membros inferiores em 21 pacientes com diagnóstico presuntivo de radiculomielite esquistossomótica. O padrão eletromiográfico de 95,2 por cento dos casos foi de multirradiculopatia axonal lombo-sacra, havendo extensão variável de desnervação, com predomínio de L2 a S2. Foram identificados graus variáveis de paraparesia, havendo evolução motora mais favorável nos pacientes com envolvimento de menor número de raízes. A eletromiografia poderá fornecer dados prognósticos da evolução motora dos pacientes com radiculomielite esquistossomótica.

Neuroschistosomiasis in myeloradicular pattern is frequently observed in patients from Northeast of Brazil. Despite of this, the evolution of neurologic and electromyografic patterns is not well studied in this group of patients. The aims of this study were to describe and compare the clinic and electromyografic abnormalities of patients with neuroschistosomiasis and radicular involvement. We analyzed 21 electromyographic exams of the lower limbs carried out in the initial presentation of the disease. Electromyographic pattern of 95.2 percent of patients was compatible to axonal lombosacral multirradiculopathy, with variable denervation extension, but predominanthy from levels L2 to S2. There was variable degree of deficit in the lower limbs, and the follow-up of motor disturbances was better more frequently when the roots were involved in smaller number. Electromyography should permit to know the motor prognosis of patients with myeloradiculitis due schistosomiasis.

Morbidity of schistosomiasis mansoni in the state of Minas Gerais, Brazil

From 2002 to 2005, a program of active search for patients with hepatosplenic schistosomiasis and schistosomal myeloradiculopathy has been implemented in the state of Minas Gerais by the local Health Department. The state was divided in 28 regional health centers and the local representatives have been trained to identify and direct patients with hepatosplenic schistosomiasis and neuroschistosomiasis to a reference center in Belo Horizonte, the capital of the state of Minas Gerais. Seventy five patients with hepatosplenic schistosomiasis and 54 with schistosomal myeloradiculopathy have been referred and examined in the reference center in a period of time of 3 years. Schistosomal myeloradiculopathy should be emphasized because the number of cases reported is increasing rapidly and when timely diagnosed and treated, they respond promptly to treatment. Left untreated, they die or become invalid for life. In our view, the time has come for more active investigation of the different aspects of morbidity caused by schistosomiasis mansoni in Brazil.