Cerebral Sparganosis in Children: Epidemiologic and Radiologic Characteristics and Treatment Outcomes: A Report of 9 Cases

World Neurosurg. 2016 May:89:153-8. doi: 10.1016/j.wneu.2016.01.086. Epub 2016 Feb 6.

Abstract

Background: Pediatric cerebral sparganosis has been seldom reported. In the current study, we retrospectively reviewed the clinicopathologic records of 9 consecutive pediatric cases of cerebral sparganosis and analyzed their epidemiologic characteristics and clinical outcomes.

Methods: Our cases included 6 boys and 3 girls, all from rural areas, and their median age at diagnosis was 9.4 (range, 5.8-12.9) years. The median duration of symptoms from onset to definite diagnosis was 21 months (range, 1 week to 3.7 years).

Results: Enzyme-linked immunosorbent assay revealed that serum anti-sparganosis antibody was positive in 9 of 9 patients and cerebrospinal fluid anti-sparganosis antibody was positive in 4 of 6 patients. Eight patients underwent craniotomy the removal of worms. The patients also received oral praziquantel. They were followed up for 2.2 years to 4.4 years. One patient died, and 8 patients survived. Three cases had poor outcomes whereas the outcome of the remaining 5 cases was satisfactory.

Conclusions: Children are more at risk for sparganosis and cerebral sparganosis may be missed because of unclear epidemiologic history and nonspecific manifestations. Cerebrospinal fluid eosinophil counts and enzyme-linked immunosorbent assay for anti-sparganosis antibody and computed tomography/magnetic resonance imaging scans may be relied on for an early and accurate diagnosis before surgery.

Keywords: Cerebral sparganosis; Clinical outcomes; Clinicopathologic; Pediatric.

MeSH terms

  • Adolescent
  • Antibodies, Helminth / blood
  • Antibodies, Helminth / cerebrospinal fluid
  • Biomarkers / blood
  • Biomarkers / cerebrospinal fluid
  • Brain / diagnostic imaging
  • Brain / surgery
  • Brain Diseases / diagnostic imaging*
  • Brain Diseases / epidemiology
  • Brain Diseases / therapy*
  • Central Nervous System Helminthiasis / diagnostic imaging*
  • Central Nervous System Helminthiasis / epidemiology
  • Central Nervous System Helminthiasis / therapy*
  • Child
  • Craniotomy
  • Early Diagnosis
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Retrospective Studies
  • Rural Population
  • Sparganosis / diagnostic imaging*
  • Sparganosis / epidemiology
  • Sparganosis / therapy*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antibodies, Helminth
  • Biomarkers