Đang chuẩn bị liên kết để tải về tài liệu:
Tropical Neurology - part 7

Cụ thể hóa trị liệu và các corticosteroid đã được dùng cho bệnh nhân NSJ não liên quan với các Katayama syndrome.9 Theo công bố báo cáo ban đầu, điều trị cụ thể có kết quả hồi phục hoàn toàn trong một vài bệnh nhân, và một phần phục hồi gần như hoàn tất đa số . | Neuroschistosomiasis 319 Fig.17.10 Spinal cord NSM. MRI scan of the thoracolumbar region after gadolinium injection. There is enlargement of the conus medullaris with spotty contrast-enhancement courtesy of Dr. J.R. Lambertucci . 17 320 Tropical Neurology Fig. 17.11. Spinal cord NSM. CT scan shows spinal cord atrophy at the T8 level in a patient a few months after the initial clinical presentation Courtesy of Dr. T.C.A. Ferrari . 17 Specific chemotherapy and corticosteroids have been administered to patients with cerebral NSJ associated with the Katayama syndrome.9 According to the initial published reports specific treatment has resulted in full recovery in a few patients and to a partial to near-complete recovery in the majority. In a more recent study a patient with cerebral NSJ associated with Katayama syndrome showed clearance of neurological and CT abnormalities following treatment with corticosteroids alone. The use of praziquantel in conjunction with corticosteroids however is recommended to eradicate adult worms living in sites close to the CNS and in other organs for preventing the further deposition of eggs. The use of antischistosomal drugs have been recommended for the treatment of spinal cord NS.3 6 A dramatic improvement associated with the use of an antischistosomal drug alone was observed in several patients. Patients who did not receive antiparasitic chemotherapy and had spontaneous improvement or improvement following surgery or corticosteroid may have recurrence of signs and symptoms later. It is possible that such recurrence was due to the additional egg laying in nervous tissue. Antischistosomal agents were part of the treatment schedule in most patients submitted to combined treatment who had a favorable outcome. In the early stage of spinal cord NS administration of prednisolone or dexamethasone alone can result in marked improvement. Although results of corticosteroid therapy in spinal cord NS remain controversial the available literature .