Brain, Vol. 116, No. 3, 603-616, 1993
© 1993 Guarantors of Brain
research-article |
Neurotrichinosis
A cerebrovascular disease associated with myocardial injury and hypereosinophilia
1Department of Medical Emergencies Paris, France 2Department of Pathology Paris, France 3Department of Neurorodiology, Henri Mondor Hospital, Creéteil Paris, France 4Department of Parasitology, Cochin-Port Royal Hospital Paris, France 1Department of Medical Emergencies Paris, France 2Department of Pathology Paris, France
Correspondence to:
Correspondence to: Professor R. K. Gherardi, Département de Pathologie, Hospital Henri Mondor, 94010 Créteil Cedex, France.
The clinical features, brain computerized tomography (CT) scans and cardiological findings of nine patients with neurotrichinosis are reviewed. Neurological signs consisted of encephalopathy and focal deficits with small hypodensities in the cortex and white matter, detected by the CT scans. Various cardiovascular events were also observed in eight out of nine patients. They were usually concomitant with neurological symptoms and mainly consisted of myocardial injury as assessed by electrocardiographic and plasma creatine phosphokinase (CPK)-MB isoenzyme changes. The cardio-neurological syndrome developed early in the course of the disease at a time of marked hypereosinophilia and the percentage of patients with eosinophilia >4000 mm3 was significantly higher in the patients with neurological dysfunction than in those without neurological signs.
We selected the following criteria to describe the distinctive cardio-neurological syndrome related to trichinosis: (i) early onset of neurological symptoms (within a few days) after the first general symptoms; (ii) central nervous system involvement consisting of both diffuse encephalopathy and focal neurological deficits, usually of simultaneous onset; (iii) concomitant acute myocardial injury and/or infarction; (iv) marked hypereosinophilia (>4000/mm3 at time of first cardio-neurological events; (v) brain CT scan showing small hypodensities in the hemispheric white matter or cortex.
Post-mortem examination of one patient revealed ischaemic lesions with multiple arteriolar microthrombi in the brain and myocardium. This was consistent with the brain CT scan and electrocardiographic data and suggested that neurotrichinosis is an expression of a multi-organ disorder associated with hypereosinophilia, that is characterized in most patients by simultaneous neurological and myocardial manifestations basically related to ischaemia.
Received April 22, 1992. Revised August 20, 1992. Accepted September 30, 1992.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Tint, M. E. Cocuz, O. F. Ortan, M. D. Niculescu, and M. Radoi Cardiac Involvement in Trichinellosis: A Case of Left Ventricular Thrombosis Am J Trop Med Hyg, August 1, 2009; 81(2): 313 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Gottstein, E. Pozio, and K. Nockler Epidemiology, Diagnosis, Treatment, and Control of Trichinellosis Clin. Microbiol. Rev., January 1, 2009; 22(1): 127 - 145. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. G. Madariaga, E. R. Cachay, and D. S. Zarlenga A Probable Case of Human Neurotrichinellosis in the United States Am J Trop Med Hyg, August 1, 2007; 77(2): 347 - 349. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. JAUREGUIBERRY, S. ANSART, L. PEREZ, M. DANIS, F. BRICAIRE, and E. CAUMES ACUTE NEUROSCHISTOSOMIASIS: TWO CASES ASSOCIATED WITH CEREBRAL VASCULITIS Am J Trop Med Hyg, May 1, 2007; 76(5): 964 - 966. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Sarazin, E Caumes, A Cohen, and P Amarenco Multiple microembolic borderzone brain infarctions and endomyocardial fibrosis in idiopathic hypereosinophilic syndrome and in Schistosoma mansoni infestation J. Neurol. Neurosurg. Psychiatry, February 1, 2004; 75(2): 305 - 307. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. V. Hirschmann What Killed Mozart? Arch Intern Med, June 11, 2001; 161(11): 1381 - 1389. [Full Text] [PDF]
|
|