Unraveling the enigma of spinal cord schistosomosis: clinical spectrum, diagnosis, and therapeutic insights.

Spinal cord schistosomosis is a rare but significant cause of myelopathy, ranging from asymptomatic egg deposits to severe transverse myelitis. Common in endemic regions, S. mansoni myelopathy presents as acute paraplegia or cauda equina syndrome. Diagnosis involves identifying ova in stool, urine, or rectal biopsy, accompanied by peripheral eosinophilia. Treatment includes praziquantel and corticosteroids, with laminectomy reserved for specific cases. Prognosis varies, with around one-third recovering completely, one-third with residual deficits, and one-third remaining unchanged or deteriorating, particularly in necrotic myelitis. Recognition in endemic areas is critical for timely intervention and improved outcomes in this potentially treatable myelopathy.