Spinal Cord Lesions in Congenital Toxoplasmosis Demonstrated with Neuroimaging, Including Their Successful Treatment in an Adult.

[congenital toxoplasmosis]

Neuroimaging studies for persons in the National Collaborative Chicago -Based Congenital Toxoplasmosis Study (NCCCTS ) with symptoms and signs referable to the spinal cord were reviewed . Three infants had symptomatic spinal cord lesions , another infant a Chiari malformation , and another infant a symptomatic peri-spinal cord lipoma . One patient had an unusual history of prolonged spinal cord symptoms presenting in middle age . Neuroimaging was used to establish her diagnosis and response to treatment . This 43 year -old woman with congenital toxoplasmosis developed progressive leg spasticity , weakness , numbness , difficulty walking , and decreased visual acuity and color vision without documented re -activation of her chorioretinal disease . At 52 years of age , spinal cord lesions in locations correlating with her symptoms and optic atrophy were diagnosed with 3 Tesla MRI scan . Treatment with pyrimethamine and sulfadiazine decreased her neurologic symptoms , improved her neurologic examination , and resolved her enhancing spinal cord lesions seen on MRI .