Neuroschistosomiasis and the Central Nervous System

Abstract

Schistosomes are the main cause of the neglected tropical disease schistosomiasis. As one of the most serious clinical consequences, neuroschistosomiasis occurs when the host exhibits an inflammatory reaction to eggs of schistosomes laid in the brain and the spinal cord. Two major kinds of neuroschistosomiasis are cerebral schistosomiasis and spinal schistosomiasis, which are associated with different types of schistosomes. Cerebral schistosomiasis can be acute, which leads to symptoms such as fever, delirium, visual impairment, ataxia, and headache, whereas chronic cerebral schistosomiasis usually causes epilepsy, brain tumor, and stroke. With regard to spinal schistosomiasis, the most common manifestation is acute myelopathy. Three treatments are effective for neuroschistosomiasis nowadays: schistosomicidal drugs, steroids, and surgical intervention. In terms of prevention, no vaccine is currently available, and avoiding contact with fresh water contaminated with schistosomes is the most effective way. Though neuroschistosomiasis has been increasingly reported, it is still under-recognized in many areas. Since early diagnosis and treatment significantly impact the prognosis of neuroschistosomiasis, it is crucial to improve the diagnostic approaches and treatments further to decrease the potential damage to the central nervous system. Also, the necessity of neuroschistosomiasis prevention should be emphasized to directly reduce the burden of this disease.