Neuroschistosomiasis in Young Filipino Patient Presenting with Seizure

Neuroschistosomiasis, a rare manifestation of schistosomiasis affecting the central nervous system (CNS), can result in severe neurological complications if not promptly diagnosed and treated. The condition arises due to the development of granulomas around eggs that become lodged within the CNS. Here we present a case report involving a young Filipino individual who had recurrent, uncontrolled seizures, ultimately attributed to neuroschistosomiasis. On magnetic resonance imaging revealed that the patient had brain lesions consistent with neuroschistosomiasis. Concurrently, serologic tests revealed high titres of anti-schistosoma antibodies. Effective treatment encompassed the administration of corticosteroids and praziquantel, leading to a favourable clinical outcome. This case underscores the necessity of considering neuroschistosomiasis in seizure patients, particularly in regions where the condition is prevalent, and highlights the diagnostic and therapeutic complexities posed by the absence of a biopsy.

Learning points: Diagnostic challenge and insightThis case highlights the importance of considering a broad differential diagnosis in patients with atypical neurological presentations, particularly in those from regions where parasitic infections are endemic. The internist plays a crucial role in integrating clinical, serological, and imaging data to arrive at a correct diagnosis, in this case, neuroschistosomiasis.Tailored treatment strategyThe case illustrates the value of personalized patient care. Initiating empirical treatment based on a combination of clinical suspicion, high-risk patient demographics, and imaging findings, without invasive procedures, demonstrates the internist's role in managing complex cases where patient preferences must be balanced with medical necessity.