ø ٷ ּ. εԴϴ.

Paragonimus د

Review of Literature and Report of Four Cases

ȸ 1962 5 7ȣ p.78 ~ 89
Oh Shin-Joong,
 ( Oh Shin-Joong ) - the National Medical Centre Deptarment of Neurology


丶(Cerebral Paragonimiasis) ϳμ د Ŵ ̴. ׷ κ ۸ ͱǴ ϴ.
Ѻ 1961Ҵ 6ź 1962Ҵ 5ű 4 丶 د(Paragonimus Meningitis) κϿ⿡ ̿ ͱϸ  ߾ ͱ 5ǿ Բ Ͽ.
(1) 1Ǵ 丶 18 μ 2 د ״. ̸ жد̸ Ͽ.
(2) 2Ǵ 丶 28 μ 3 ͩ د Ű. ̸ 1ǿ Ͽ.
3) 3Ǵ 丶 9 μ دδ ־ ̸ د̸ Ͽ ӿ ߫Ϲ ̸ۡҼ־.
4) 4Ǵ 丶 Ҵμ دѢ Ͽ ̾ ̸ ǿ Ͽ.
5) ߾ ͱ 5ǿ Բ ̿ ̿ .
د ͧ丶 Լ ̸ۡ Ǵ 丶 ܱ Ÿ ִ.
ܻۡ ۡ ϥΰ ϸ ϱ⵵ Ѵ. ˭ Kernig Sign ӿ Ͽ. 4ǿ ٴ د , Φ(Irritability), ų ̾.
̸ жد ̸ Ͽ. (Sugar) ӿ Ǿ ְ ڪ(chloride) ̰ų Ǿ ִ. ӿ ߫Ϲ ־ 丶(P.W.) հ ̸ۡϿ.
ͱ  ӿ ̿د Ͽ 츮 ̿د ܬ ʵdz ܻ, ߾  ϰ ܬӨ߾ ū ȴ.

It is generally recognized that the development of cerebral paragonimiasis in a proportion of case has followed an initial meningitic attack. Lee has thus reported that 9 out of 11 cases had a past history of a meningeal syndrome, which subsided spontaneously within three to seven days. In the 33 cases we have seen during the past three years, 7 of the patients have presented such a history.
Also in the classification of cerebral paragonimiasis a meningitic type is usually included. Ipsikhiat2 has thus divided the symtomatology into four categories: (1) encephalitic, (2) meningeal, (3) epileptoid and (4) tumorous. Kim3 has described the cerebral menifestations under four headings: (1) seizures, (2) sudden hemiplegia, (3) meningitic syndrome, and (4) mental retardation. He observed in 6 of, his 47 cases a chronic meningitis with headache, stiff neck, vomiting and a low grade fever as. the predominant symptom.
There is thus a clinical as well as a pathological foundation for the assumption of a meningitis as the only or the predominant clinical menifestation of cerebral paragonimiasis.
In contrast to such a frequent history of meningitic episodes in the case reports of cerebral paragonimiasis, there are rather few reports of meningitis which has been observed during hospitalization and thoroughly studied.
The first publication of this kind is from Japan in 1933- by Ikebukuro4 who reported a case of a male patient who was admitted to his clinic with chief complaints of sudden development of left hemiplegia, vomiting, frontal headache, and It. facial palsy. The spinal fluid findings showed raised pressure, increased cells with many two segmented eosinophiles, increased protein, decreased sugar and cholride, meingitic colloidal gold curve, and negative result for any pathogenic organisms. This patient was suspected of "tuberculous meningitis" prior to autopsy which disclosed "cerebral paragonimiasis".
Three other publications have appeared, also from Japan: by Matzumura5) in 1933, by Konuma and Kanzakisl in 1936, by Yamada7 in 1938. In 1941, Nonomuras published -a case which he simply called paragonimus parasitic meningitis. He -found that 98 % of the cells in the spinal fluid were eosinophiles.
Author has observed four cases of paragonimus meningitis during the past six months. In addition to presenting four cases, all available previous publications are reviewed in an attempt to establish certain clinical criteria of this aspect of the disease which often may be difficult to recognize