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CC BY-NC-ND 4.0 · Asian J Neurosurg 2025; 20(02): 378-382
DOI: 10.1055/s-0044-1801377
Case Report

Sparganosis of the Cauda Equina: A Rare Case of Lower Thoracic Cord Edema and Diagnostic Challenges

Authors

  • Prasert Iampreechakul 

    1   Department of Neurosurgery, Neurological Institute of Thailand, Bangkok, Thailand

  • Chonlada Angsusing

    2   Department of Neuroradiology, Neurological Institute of Thailand, Bangkok, Thailand

  • Sunisa Hangsapruek

    2   Department of Neuroradiology, Neurological Institute of Thailand, Bangkok, Thailand

  • Samasuk Thammachantha

    3   Department of Pathology, Neurological Institute of Thailand, Bangkok, Thailand

  • Adisak Tanpun

    4   Division of Neurosurgery, Department of Surgery, Phrapokklao Hospital, Chanthaburi, Thailand

Funding None.
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Abstract

Sparganosis is a rare parasitic infection caused by the larvae of Spirometra species, with spinal involvement being exceedingly uncommon. We present the case of a 46-year-old woman with progressive lower limb weakness, sensory deficits, and bowel and bladder dysfunction over a 3-month period. Initial magnetic resonance imaging revealed an abnormal intradural lesion from L2 to S2, along with thoracic spinal cord edema, raising suspicion for a spinal dural arteriovenous fistula (DAVF). After referral to our institution, further imaging ruled out DAVF, and findings suggested arachnoiditis and radiculitis of the lumbosacral nerve roots. The patient underwent a laminectomy, revealing inflamed arachnoid membranes and diffuse yellowish-whitish granulation tissue adherent to the cauda equina, which histopathological analysis confirmed as sparganosis. Postoperatively, the patient showed improved motor strength, although bowel and bladder dysfunction persisted. This case highlights the diagnostic challenges of spinal sparganosis, the need for early surgical intervention, and the importance of considering parasitic infections in endemic regions.

Keywords

sparganosis - cauda equina syndrome - thoracic spinal cord edema - parasitic infection - lumbosacral arachnoiditis

Note

This study was reviewed and approved by the institutional review board.


Authors' Contributions

P.I. contributed to conceptualization, methodology, original draft preparation, and reviewing and editing the manuscript. C.A. handled data curation and validation. S.H. contributed through investigation, while S.T. managed data curation, visualization, and validation. A.T. provided resources essential to the study.




Publication History

Article published online:
30 December 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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