Leptomeningeal Schistosomiasis: A Case Report of an Atypical Location of Neuroschistosomiasis Presenting as Adult-Onset Seizure

Abstract

We report a case of a 19-year-old male, single, right-handed, student, Filipino currently living in Novaliches, Quezon City who consulted for the first time at our institution due to stiffening of extremities with a pertinent travel history from the Island of Samar. Evaluation and diagnostics showed a leptomeningeal enhancement and thereafter, a biopsy was made revealing deposition of schistosoma ova at the leptomenineal area. Schistosomiaisis (also known as Bilharzia or Blood Fluke Disease) is widely distributed in the Philippines affecting 24 provinces in Luzon, Visayas, and Mindanao, with 5 million people at risk and approximately 1 million affected in the year 2003. Cerebral schistomiasis is a severe and neglected complication which occurs in less than 5% of infected individuals. Symptoms are non-specific such as headache, vomiting, confusional states, and focal seizures. Typical neuroimaging findings are expected at the spinal cord, cerebellum, and the subcortical area, however leptomeningeal involvement is rarely reported. We report this case to the medical community to give light on the different presentations of the said disease