Category: Myoclonus
Objective: While various neurological symptoms of sparganosis including have been reported, this is the first documented instance in which sparganosis presented with myoclonus.
Background: Sparganosis is a rare infection caused by parasitic tapeworms of the genus Spirometra, known to be transmitted through ingesting freshwater or raw meat, or via direct contact through an open wound. While sparganosis features a wide variety of clinical presentations including dermatological, muscular, ocular and neurological abnormalities, this is the first documented instance in which sparganosis presented with myoclonus.
Method:
A. Physical examination
B. X-rays of the lower legs
C. CT Brain
D. 3T head MRI
E. Electroencephalogram (EEG) , Nerve conduction study (NCS) and Motor evoked potential (MEP) with somatosensory evoked potential (SSEP)
Results: A. There was a well-circumscribed, oval-shaped erythematous papule on the right leg, approximately 7.5 cm inferior to the right patella. Size was approximately 3mm in diameter. There was a rubbery consistency and absence of tenderness upon palpation.
B. X-rays of the lower legs were unremarkable.
C. CT Brain showed presence of right maxillary sinusitis.
D. 3T head MRI revealed minimal small vessel ischemic lesions in the white matter of both hemispheres, and ruled out an aneurysm (3mm) in the region surrounding the left posterior communicating artery.
E.EEG showed repetitive 5Hz sharp waves. There were no pathological rhythms or epileptic discharges. Nerve conduction study was normal. Motor evoked potential and somatosensory evoked potential of both legs were unremarkable.
Conclusion: This was the case of a 65-year-old Korean male who presented to the ER with pruritus and involuntary movement in his right leg. Physical examination revealed a well-circumscribed red papule on his right leg with a diameter of approximately 3mm and rubbery consistency. The lesion was initially suspected to be a lymphoma, lipoma or cyst but a Sparganum larva was detected in his punch biopsy specimen, and the patient was ultimately diagnosed with Sparganosis.
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To cite this abstract in AMA style:
EJ. Choi, DG. Lee, AR. Lim. A Man Who Has Been Presenting with Pruritus and Myoclonus [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/a-man-who-has-been-presenting-with-pruritus-and-myoclonus/. Accessed September 7, 2024.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/a-man-who-has-been-presenting-with-pruritus-and-myoclonus/