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Bilharzial granuloma of the conus medullaris and cauda equina
| Content Provider | Paperity |
|---|---|
| Author | El-banhawy, Ahmed Taher, Yehia Elwan, Osamah |
| Abstract | Although 200 million people are infested with bilharziasis all over the world, few reports of involvement of the spinal cord, conus medullaris and cauda equina by schistosoma worms or ova appear in the literature. During a period of three years, the authors came across five patients with involvement of the conus medullaris and cauda equina that were operated upon and thus verified pathologically. Case summaries of these are presented.Clinically, the patient is generally a boy in his second decade who develops low back pain and sciatic pains and profound sphincteric disturbances. Paraparesis soon follows and often progresses rapidly to inability to walk within a few days or weeks. Examination of urine, stool and a rectal biopsy, the usual laboratory procedures to discover bilharzia ova, are much more frequently negative than positive.Serological tests (circumoval and precepitin) of the C.S.F., especially if the titre is compared to that of the blood serum, are likely to give a specific indication of involvement of the central nervous system.In the authors' opinion, the myelographic appearance is specific. The bilharzial granuloma produces an abrupt intramedullary block, the length of one vertebral body, strictly located opposite T12 and L1 with irregular and often trifid edges.Bilharzial myelitis and early granuloma of the conus medullaris and cauda equina, the former rarely seen and the latter rarely diagnosed at such a stage, may be cured by antibilharzial chemotherapy (the authors used potassium antimony tartarate).Advanced granulomas are best managed by a combination of wide surgical decompression in addition to chemotherapy. |
| Starting Page | 172 |
| Ending Page | 180 |
| File Format | HTM / HTML |
| ISSN | 14765624 |
| DOI | 10.1038/sc.1972.29 |
| Journal | Spinal Cord |
| Volume Number | 10 |
| e-ISSN | 14765624 |
| Language | English |
| Publisher | Nature Publishing Group |
| Publisher Date | 1972-08-01 |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology Rehabilitation Neurology (clinical) |
