Conus Medularis Neuroschistosomiasis In A 12-Year-Old Boy

Abstract

Introduction: Neuroschistosomiasis, an infrequent consequence of schistosomal infection, typically presents with deteriorating motor  and sensory function coupled with sphincter dysfunction. Diagnosis involves a clinical history, physical examination, cerebrospinal fluid studies, and imaging.

Case report: We detail the case of a 12-year-old boy hailing from Machakos County, who manifested lower limb  weakness and urine retention for two weeks. Examination unveiled diminished lower limb tone and areflexia, with a power grade of 0 in distal muscles below the knee and normal muscle bulk. Magnetic resonance imaging revealed a cauda equina region tumor. Subsequent  histopathology after tumor-debulking surgery unveiled schistosomal-associated necrotizing granulomatous inflammation. Following  tumor resection at T1-L1 and receipt of histopathology results, the patient underwent optimum pain management and praziquantel  therapy. Clinical improvement ensued, albeit with distal paralysis.

Conclusion: Our case highlights the necessity of heightened suspicion  for cauda equina tumors in young patients from schistosoma-endemic regions, advocating early diagnosis and management involving  praziquantel treatment.