Radiculomyeloencephalitis Associated with Eosinophilic Pleocytosis

Abstract
Summary Eosinophilic encephalitis with manifestations of headache, paresthesia, and paralysis of cranial nerves VI and VII is well recognized in Thailand, but radiculomyeloencephalitis with eosinophilic pleocytosis has not been reported. In nine cases, six men and three women, there were sharp, shooting pains of the trunk and limbs. Flaccid paralysis and impairment of superficial sensation occurred. Cerebrospinal fluid showed between 92 and 880 white cells per cmm, 24 to 55% eosinophils in all cases, and increased protein in eight. Two patients died suddenly. The autopsy in one case showed a long necrotic, hemorrhagic track in the spinal cord and perivascular infiltration of plasma cells and eosinophils in the cord and midbrain. Parasites were not detected. The parasite causing spinal-cord involvement is most likely not Angiostrongylus cantonensis, which produces typical eosinophilic meningitis.

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