It is a disease caused by adult lung flukes (Chinese Taxillus Herb) in the brain that continuously migrate, with the temporal lobe being the most frequently affected.

bubble_chart Clinical Manifestations

The main symptoms include meningoencephalitis, increased intracranial pressure, epilepsy, paralysis, hemianopia, etc., and the cerebellum may occasionally be affected. 1. **Meningoencephalitis**: More common in the early stages of the disease, presenting with chills, fever, vomiting, severe headache, and meningeal irritation signs such as neck stiffness and a positive Kernig's sign. Cerebrospinal fluid pressure is elevated, with an increased cell count—mostly eosinophils—and protein levels may also rise. The migration of parasites in the brain leads to lesion expansion. 2. **Increased intracranial pressure**: Often occurs when larvae invade the ventricles, obstructing cerebrospinal fluid circulation, or due to cerebral congestion, inflammatory cell infiltration, and edema, mostly in the early stages. Key symptoms include headache, vomiting, dull facial expression, and optic disc edema. Elevated intracranial pressure can cause the third ventricle to bulge cyst-like at the base of the brain, compressing the optic nerve and leading to vision impairment or blindness. 3. **Brain tissue damage**: Symptoms include limb paralysis (hemiplegia, monoplegia, paraplegia, or crossed paralysis), sensory loss, aphasia, hemianopia, and ataxia. These symptoms appear later, with fluctuating severity, eventually resulting in permanent deficits. **Cortical irritation symptoms**: Include epilepsy, headache, visual hallucinations, and limb paresthesia, with epilepsy being the most common. Before seizures, patients may experience headaches, limb numbness, or fear as precursors, though some cases occur suddenly without warning. Seizures often start with facial or upper limb twitching, progressing to generalized tonic spasms, upward eye deviation, mouth deviation, and urinary incontinence. Seizure frequency and intervals vary, with some patients experiencing status epilepticus, primarily due to parasite lesions near the cerebral cortex. 4. **Psychiatric symptoms**: Some cerebral paragonimiasis patients may exhibit psychiatric symptoms such as confusion, dull expression, slurred speech, slow reactions, memory decline, or drowsiness. Those with brain atrophy show significant cognitive decline. A few cases may experience visual hallucinations, hysterical episodes, or prolonged coma lasting months.

1. It often presents with symptoms of cerebral membrane inflammation or subarachnoid hemorrhage, followed by focal neurological signs; or manifests as progressive intracranial hypertension and symptoms resembling a brain tumor.

2. Eggs may be found in sputum and cerebrospinal fluid. Occasionally, the parasite itself is detected in subcutaneous nodule biopsies.

3. The intradermal test for Paragonimus antigen is positive. Eosinophils are elevated in blood and cerebrospinal fluid.

4. Skull X-rays may show calcified cyst walls. Cysts can be visualized on head CT scans and MRI.

5. Differential diagnosis includes other cerebral membrane inflammations, encephalitis, and space-occupying lesions.

bubble_chart Treatment Measures

The adult daily dose of bithionol is calculated at 50-60mg/kg, divided into 3 doses taken every other day, with a treatment course lasting 10-15 days. This can be repeated for 2-3 courses. For chronic sexually transmitted disease cases and those with space-occupying symptoms, surgical treatment may be combined.