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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eosinophilic meningitis is due to infestation of the nervous system by the larvae of Angiostrongylus cantonensis. The infection is from infected prawns and slugs. In a study of 54 patients from Tahiti the leading symptoms were headaches, neck stiffness, limb pains and sometimes a facial palsy. The diagnosis is made by examination of the CSF when the leucocytes are usually over 100/mm3 and over half are eosinophilic cells. The blood eosinophil count is often raised, above 400/mm3. The disease is self-limiting and there is no known specific treatment.
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PMID:Eosinophilic meningitis in Tahiti: clinical study of 54 patients. 28 29

Eosinophilic meningitis, also named human nervous angiostrongyliasis, results from the infestation of the Nervous System by larvae of Angyostrongylus Cantonensis realizing there a parasitic deadlock. The Authors studied 54 patients whose main complaints were severe and lasting headache, and paresthesias. A meningitic syndrome is not always encountered and a facial paralysis of the lower motor neuron type has been noted in a few patients. Study of the Cerebrospinal fluid shows pleiocytosis with a variable percentage of eosinophiles. Complete recovery is usual after a couple of weeks and the prognosis can be given as excellent despite of the fact that no specific therapy is known at the present time.
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PMID:[Eosinophilic meningitis (author's transl)]. 60 Jul 53

Eosinophilic meningitis or meningoencephalitis is a disease commonly seen in Taiwan, especially in children during the summer rainy season. Most of the cases reported in other countries were adults and their clinical manifestations were different from children. Studies on special clinical characteristics among 87 children in Taiwan were performed. Thirty-eight (43.7%) were male and 49 (56.3%) females, and 88.5% could be traced to a history of contact with the intermediate host, the giant African snail, Achatina fulica, which plays a major role in transmission. The incubation period (average: 13.0 days) was shorter in children than in adults (average: 16.5 days). Near thirty percent (28.7%) of the total cases, the clinical form was meningoencephalitis, which was higher than in adult cases seen in Thailand (5%). The most common clinical symptom was fever (92.0%), followed by vomiting and headache. The percentages of sixth and seventh cranial neuropathy associated with the disease were 17.2% and 11.5% respectively. Ophthalmologic fundoscopy showed that 23.0% with papilledema which was significantly higher than seen in adults (12%) in Thailand. Most of the cases in this study had peripheral leukocytosis (above 10,000/mm3) and eosinophilia (above 10%); the percentages were 83.9% and 85.1%, respectively. The worm recovery rate from cerebrospinal fluid by lumbar puncture of 87 cases was 43.7%; 141 worms were collected from one female patient using a pumping method. In the recent 3 years, levamisole was used clinically with good result.
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PMID:[Eosinophilic meningitis and meningoencephalitis in children]. 818 88

Angiostrongylus cantonensis is the most common cause of eosinophilic meningitis worldwide. Human infection occurs after ingestion of the worms in raw snails or fish that serve as intermediate hosts. Two outbreaks of central nervous system infection with A. cantonensis occurred in Kaoshiung, Taiwan, during 1998 and 1999 among Thai laborers who ate raw snails. A detailed clinical studies of 17 of these patients was conducted, including study of 13 patients who underwent magnetic resonance imaging (MRI) scans of the brain. The MRI scans revealed high signal intensities over the globus pallidus and cerebral peduncle on T1-weighted imaging, leptomeningeal enhancement, ventriculomegaly, and punctate areas of abnormal enhancement within the cerebral and cerebellar hemisphere on gadolinium-enhancing T1 imaging, and a hyperintense signal on T2-weighted images. There was a significant correlation between severity of headache, cerebrospinal fluid (CSF) pleocytosis, and CSF and blood eosinophilia with MRI signal intensity in T1-weighted imaging (P < 0.05). Eosinophilic meningitis produced by A. cantonensis needs to added to the list of causes of hyperintense basal ganglia lesions found on T1-weighted MRI scans in tropical countries.
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PMID:Eosinophilic meningitis caused by Angiostrongylus cantonensis associated with eating raw snails: correlation of brain magnetic resonance imaging scans with clinical findings. 1268 30

Eosinophilic meningitis (EM) is a distinct clinical entity that may have infectious and noninfectious causes. Worldwide, infection with the helminthic parasite, Angiostrongylus cantonensis, is the most common infectious etiology. Historically, this infection has been acquired through ingestion of competent intermediate and paratenic (carrier) hosts or contaminated food in Southeast Asia and the Pacific Islands. A recent outbreak of A. cantonensis-associated EM among US travelers to Jamaica and subsequent parasitologic surveys of local snails and rats confirm earlier case reports and engender a wider appreciation of the Caribbean islands as a new region for endemic A. cantonensis infections. Clinically, eosinophilia is not always present in the cerebrospinal fluid or in the peripheral blood during the initial manifestions of A. cantonensis-associated EM, which include headache and cutaneous sensory alterations. Effective management of patients involves careful attention to the control of intracranial pressure. Steroid therapy without specific anthelmintic treatment is safe and effective in control of headache of adult patients with A. cantonensis-associated EM.
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PMID:Eosinophilic Meningitis. 1286 84

Eosinophilic meningitis in humans is commonly caused by the nematode Angiostrongylus cantonensis. A severe headache is the most common presenting symptom. A prospective, randomized, double-blind, placebo, controlled study was conducted to determine if albendazole was efficacious in relieving such headaches. Seventy-one patients (36 and 35 in the treatment and control groups) were enrolled in the study. Five patients (two and three in the treatment and control groups) were excluded from the study because of being lost to follow-up, and the clinical data were incomplete. Therefore, 34 and 32 patients in the treatment and control groups were studied, respectively. Albendazole was administered at 15 mg/kg/day or identical placebo for 2 weeks. The number of patients with persistent headaches after 2 weeks was 7 and 13 in the albendazole and placebo groups (p = 0.08), respectively. The mean duration of a headache was 8.9 and 16.2 days in the albendazole and placebo groups, respectively (p = 0.05). No serious drug events were observed. A 2-week course of albendazole appeared to reduce the duration of headache in eosinophilic meningitis.
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PMID:Albendazole therapy for eosinophilic meningitis caused by Angiostrongylus cantonensis. 1717 56

Eosinophilic meningitis (EOM) associated angiostrongyliasis mostly induced by the nematode Angiostrongylus cantonensis, is a common disease with worldwide prevalence. Heavy infections can lead to chronic disabling disease and even death. This study was conducted to shed light on the overall specific IgG antibody response as well as the specific IgG antibody subclass responses in cerebrospinal fluid (CSF) of patients with EOM. Fifteen patients with EOM associated with angiostrongyliasis were included in the study. Sera were screened by immunoblotting for the presence of IgG antibody to the 29 kDaA. cantonensis antigenic polypeptide. CSF was examined by ELISA for the presence of specific IgG and IgG subclass antibodies. Patients presented with headache (100%), neck stiffness (20%), fever (40%), nausea (87%), vomiting (73%), paresthesia (7%), and muscle weakness (7%). Seven of 15 (47%) patients showed peripheral blood eosinophilia and all patients presented with eosinophils in CSF. A sensitivity of 80 % was obtained by combining the diagnostic values of immunoblotting in sera and IgG and IgG subclasses-based ELISA in CSF. The combination of a history of eating raw or semi-cooked infected foods, clinical features, complete blood count, differential cell counts, CSF profiles, and serum and CSF antibodies to A. cantonensis can be used to increase the sensitivity for the diagnosis of human angiostrongyliasis.
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PMID:Eosinophilic meningitis associated with angiostrongyliasis: clinical features, laboratory investigations and specific diagnostic IgG and IgG subclass antibodies in cerebrospinal fluid. 1753 42

Eosinophilic meningitis associated angiostrongyliasis (EOMA) is a harmful disease of the brain and spinal cord caused by a parasitic helminth, Angiostrongylus cantonensis, presenting with severe headaches and cerebrospinal fluid (CSF) eosinophilia. However, the immunologic pathophysiology especially in relation to the eosinophilic inflammation is still unknown. We measured the CSF concentrations of eotaxin and eotaxin-2 of 30 patients and 10 controls. The CSF eotaxin and eotaxin-2 levels of the EOMA patients were significantly higher than those of the controls (p<0.001). The positive detection values were 83.3% (25/30) and 93.3% (28/30) for eotaxin and eotaxin-2, respectively. CSF eotaxin-2 levels also correlated with CSF eosinophilia (p=0.002). These results might indicate that the recruitment of eosinophils to the brain and spinal cord in EOMA patients could be related to elevated eotaxin-2 levels.
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PMID:Cerebrospinal fluid eotaxin and eotaxin-2 levels in human eosinophilic meningitis associated with angiostrongyliasis. 1770 45

Eosinophilic meningitis is a rare clinical entity. The most frequent cause in travellers to the tropics is infection with the rat lungworm Angiostrongylus cantonensis. In this report, we describe a case of eosinophilic meningitis due to infection with this nematode in a traveller who presented with slight headache, diarrhoea, general malaise and thoracic radicular pain after a trip through Latin America and the Fiji Islands. She responded less than optimally to repeated steroid and albendazole treatments, but finally recovered completely.
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PMID:Eosinophilic meningitis due to Angiostrongylus cantonensis in a Belgian traveller. 1834 73

Eosinophilic meningitis is an uncommon clinical entity, which is mostly caused by Angiostrongylus cantonensis, a nematode which parasitizes rat's lungs. Humans represent a dead-end in the parasite's lifecycle and become infected by ingesting snails, slugs or transport hosts. Due to uncontrolled proliferation and circulation of snails and rats, human angiostrongyliasis has emerged in new foci in continental China. The treatment, which relies upon a combination of albendazole and corticosteroids, is still a matter of debate. In order to assess the epidemiological features of two outbreaks which occurred in Kunming, capital of the Yunnan province, 2003 and 2005, along with the clinical and treatment issues, a retro-prospective study was carried out among thirty-four clinical cases of eosinophilic meningitis. Furthermore, a parasitological survey was carried out on randomized samples of snails sold in the markets of the city On admission, all cases were found to have acute headaches and an eosinophilic pleocytosis rate > 5% in the cerebro spinal fluid (CSF). All patients reported the consumption of raw snails Pomacea canaliculata, 14 days on average before the onset of headaches (range 1-30 days). Hyperesthesia due to radiculitis was observed in 68% of the cases and the meningitis syndrome was present in 41%. The average value of blood eosinophil count in CSF and in peripheral blood was 38% and 900/ml, respectively. Two treatment schedules were used (without randomization): one with progressive doses over 4 weeks; the other with immediate high doses for 10 days with 3 sessions separated by 14-day intervals. The results were compared by the Kaplan Meier log rank test. All the cases had a favorable evolution. The analysis suggested better effectiveness and tolerance of the albendazole - dexamethasone combination used at the highest dosage, namely 20mglkg daily and 10mg daily respectively. Eosinophilic meningitis appeared to be recently emerging or re-emerging in Kunming. Deep-rooted culinary habits of eating raw food, and large amount of snails sold on local markets (about one ton per day) provide ideal conditions for the outbreak, or occurrence of this disease. According to the resdjlts of this study Chinese local authorities should be urged to improve information to the population about the risks of eating raw snails, in order to strengthen the control of both rat and snail populations and reinforce the supervision of local food markets.
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PMID:[Two outbreaks of eosinophilic meningitis in Yunann (China) clinical, epidemiological and therapeutical issues]. 1958 24


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