Nematodes

Visceral larva migrans - Toxocara canis

- Toxocara cati

- Baylisascaris procyonis

Eosinophilic meningitis

- Angiostrongylus cantonensis

Rare but serious neurological complications occur, including headache, convulsions, or behavioral changes and hemiplegia

Raccoon ascaris

The lung worm of rats. Direct invasion of the CNS produces headache, vomiting, neck stiffness, fever, paresthesias, convulsions and cranial nerve palsies (sixth or seventh nerve)

The differential diagnosis of CSF eosinophilia includes:

• CNS malignancy

• Coccidioides immitis meningitis

• Cysticercosis

• Other parasitic infections (Paragonimus westermani, Gnathostoma spinigerum, or Schistosoma species)

Trichinosis

- Trichinella spiralis

- Trichinella nelsoni

- Trichinella nativa

Approximately 10% of patients with symptomatic trichinosis develop neurological complications due to direct larval invasion of the brain (encephalitis) or CSF spaces (meningitis), producing personality changes, headache, meningismus, or lethargy. Later, focal signs such as motor or cranial nerve palsy predominate, and correlate with larval encystment. Additionally, signs of cerebellar dysfunction, convulsions, or peripheral neuropathies may occur, indicating the broad spectrum of neurological complications of symptomatic trichinosis Temperate climates Africa Arctic

Strongyloides stercoralis This nematode is endemic in tropical and subtropical regions, and is excreted in the stools of 0.4-4% of infected humans. The Strongyloides stercoralis larvae penetrate the skin and migrate to the intestines, lungs, and rarely the CNS; in the latter, they producing meningitis, infarction, or brain abscess

CNS: central nervous system; CSF: cerebrospinal fluid.

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