Cerebral paragonimiasis is an uncommon condition that can be clinically severe.
Patient: CNS migration of a Paragonimus worm
Early-stage infection may be associated with:
(1) seizures
(2) headaches
(3) hemiparesis
(4) focal neurological deficits
(5) visual deficits
(6) meningeal irritation
Late-stage infection tends to be related to the effects of a conglomerated space-occupying lesion. Eggs tend to be numerous and to persist after the worm's death, forming calcified granulomas.
The diagnosis often relies on brain imaging studies, supplemented by CSF and/or PCR and/or ELISA.
Differential diagnosis:
(1) tumors
(2) cerebrovascular disease
(3) hydrocephalus
(4) neurocysticercosis
(5) cerebromalacia
(6) tuberculosis
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