First case of human neurocoenurosis caused by Taenia serialis: A case report.

Human coenurosis is caused by the larval stages of Taenia species, mainly Taenia multiceps and Taenia serialis. T. multiceps has been reported to cause human central nervous system (CNS) infections, but no CNS case caused by T. serialis has been reported. The authors report the first case of human neurocoenurosis caused by T. serialis, which was confirmed by mitochondrial DNA analysis. A 38-year-old man presented with visual disturbance and headache, and subsequent magnetic resonance imaging (MRI) revealed a ring-enhancing cystic lesion in the left occipital lobe. Biopsy was performed, and the resultant histopathological diagnosis was that of low-grade B-cell lymphoma. Chemotherapy was initiated, but a subsequent MRI showed increased ring enhancement. Due to the unexpected clinical course, a surgical resection of the lesion was performed. The lesion was completely removed. Pathological examination showed multiple scolices with hooklets, suckers, and numerous calcareous corpuscles. Therefore, the diagnosis of neurocysticercosis was made. However, mitochondrial DNA analysis showed that the disease was definitively coenurosis caused by T. serialis. Albendazole was administered, with no evidence of recurrence at 12 months following the operation. In this study, we demonstrate that T. serialis can cause CNS infection and that genetic analysis is recommended to establish a definitive diagnosis.

Ultrastructural description of Myxobolus cuneus (Myxosporea) in the skeletal muscle and kidney of tropical farmed fish Piaractus mesopotamicus (Characiformes: Characidae).

This study characterizes by transmission electron microscopy (TEM) and morphometric features the myxozoan Myxobolus cuneus (Myxosporea) in Piaractus mesopotamicus and reports the skeletal muscle and kidney as site of infection. The register was based in 21 young fish from intensive fish farming in Southeast Brazil and the spores were analyzed in fresh-mounted slides of the infected organs stained with Toluidine blue and processed as usual for TEM. It differs from Myxobolus cunhai from the fish host and different polar capsule size, and from Myxobolus serrasalmi on the pyriform spore shape and an oval macrospore, differently to that reported in this study. Morphometric characteristics and TEM study confirmed the present material as M. cuneus.

Headache Following Occipital Brain Lesion: A Case of Migraine Triggered by Occipital Spikes?

This study describes the case of an 8-year-old boy who developed a genuine migraine after the surgical excision, from the right occipital lobe, of brain abscesses due to selective infestation of the cerebrum by Entamoeba histolytica. After the surgical treatment, the boy presented daily headaches with typical migraine features, including right-side parieto-temporal pain, nausea, vomiting, and photophobia. Electroencephalography (EEG) showed epileptiform discharges in the right occipital lobe, although he never presented seizures. Clinical and neurophysiological observations were performed, including video-EEG and polygraphic recordings. EEG showed "interictal" epileptiform discharges in the right occipital lobe. A prolonged video-EEG recording performed before, during, and after an acute attack ruled out ictal or postictal migraine. In this boy, an occipital lesion caused occipital epileptiform EEG discharges without seizures, probably prevented by the treatment. We speculate that occipital spikes, in turn, could have caused a chronic headache with features of migraine without aura. Occipital epileptiform discharges, even in absence of seizures, may trigger a genuine migraine, probably by means of either the trigeminovascular or brainstem system.

Increased frequency of headache and change in visual aura due to occipital cysticercus granuloma.

Migraine is a common clinical disorder, quite disabling and affecting the quality of life in majority of patients. The visual aura is the commonest among all types of aura. Various types of migraine aura described in the literature are photopsia, fortification spectra, scotoma, visual distortion, haemianopia and metamorphsia. The epileptic visual aura differs from aura associated with migraine in certain features: short lasting for 2-3 minutes, occurring in clusters, multicoloured and circular in shape. The ictal manifestations of occipital lobe lesions can mimic episodes of migraine with visual aura according to some reports. In this case report, we intended to highlight aggravation and increased frequency of headache attacks and changed pattern of aura induced by occipital lobe cysticercus granuloma in a patient diagnosed of migraine with aura. The importance of neuroimaging of brain in state of unexpected increased frequency of headache episodes has been emphasised.

Neurocysticercosis causing sudden death.

Neurocysticercosis causes significant morbidity due to neurologic manifestations including seizures. Sudden unexpected death in epilepsy (SUDEP) is responsible for mortality associated with seizure disorders. This case highlights death from neurocysticercosis and possible SUDEP in a nonendemic country.

The role of corticosteroids in the treatment of cerebral schistosomiasis caused by Schistosoma mansoni: case report and discussion.

A 26-year-old Brazilian man was admitted to The Toronto Hospital with a headache and visual scintillation. His last travel to Brazil was five years previously. A computed tomography (CT) scan of the head showed an occipital mass with surrounding vasogenic edema. Occipital brain biopsy revealed Schistosoma mansoni eggs. The patient was treated with two doses of praziquantel (20 mg/kg) and dexamethasone (10 mg). His symptoms and occipital mass resolved. Cerebral schistosomiasis is, in part, caused by the host's inflammatory response to Schistosoma. Modes of treatment have included surgical resection, the antiparasitic drugs oxamniquine or praziquantel, and corticosteroids. Corticosteroids may diminish granulomatous inflammation, thereby preventing further tissue destruction, and there is evidence that they also reduce ova deposition. Our review of the literature supports prompt medical therapy in patients with cerebral schistosomiasis. While the minimally or asymptomatic individual may be treated with praziquantel alone, clinicians should consider adjunctive therapy with corticosteroids for patients with prominent neurologic signs or symptoms or mass lesions with evidence of surrounding edema on a CT scan or by magnetic resonance imaging.

Cytologic diagnosis of neurocysticercosis. A case report.

We present a case of cerebral neurocysticercosis evaluated cytologically utilizing the "squash smear" technique. The parasite was very necrotic, and the smears contained numerous calcareous corpuscles only. These corpuscles were initially interpreted as psammoma bodies, quite consistent with the clinical and radiologic impression that the patient had a meningioma. However, on close examination, the corpuscles were recognized immediately as coming from a parasite. The cytologic differences between psammoma bodies and calcareous corpuscles are discussed. We also review briefly the nature of cysticercosis and its cytologic diagnosis.

Cerebral healing after craniotomy to evacuate a Coenurus cerebralis cyst.

An 11-month-old ewe developed neurological signs caused by a space-occupying lesion in the left cerebral hemisphere. Successful surgical evacuation of a Coenurus cerebralis cyst was carried out, the neurological signs regressed and the ewe produced twins in the following breeding season. Sixteen months after the surgical treatment the ewe was found dead and necropsy revealed a vegetative endocarditis. In the brain, at the site of cyst evacuation, there was a collapsed subcortical cavity lined by siderotic fibrovascular tissue and surrounded by a modest glial reaction. These observations confirm that the clinical signs of cerebral coenuriasis are related to the space-occupying effect of the parasitic cyst and indicate that partial replacement by gliomesodermal tissue plays a part in healing of the collapsed cyst.