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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