Neuroschistosomiasis: Exploring the Clinical and Epidemiological Dimensions of a Neglected Tropical Disease

Neuroschistosomiasis is a rare but severe neurological complication of schistosomiasis, a parasitic disease caused by Schistosoma species. Although primarily affecting the gastrointestinal and urogenital systems, aberrant migration of eggs or adult worms to the central nervous system (CNS) can result in significant morbidity and disability. This narrative review provides a comprehensive overview of neuroschistosomiasis, with a focus on its epidemiology, pathogenesis, clinical manifestations, diagnostic challenges, treatment strategies, and public health implications.A literature review was conducted using databases such as PubMed, Scopus, and Google Scholar to identify peer-reviewed articles, case reports, clinical guidelines, and review articles on neuroschistosomiasis. Emphasis was placed on studies describing CNS pathology, diagnostic approaches, therapeutic outcomes, and disease burden. Neuroschistosomiasis occurs in less than 5% of infected individuals but may be underreported. S. mansoni, S. haematobium, and S. japonicum are the primary species implicated. Spinal forms, presenting as transverse myelitis or conus medullaris syndrome, are most commonly seen, while cerebral forms may present with seizures, focal deficits, or signs of raised intracranial pressure. Diagnosis relies on MRI, CSF analysis, serology, and occasionally CNS biopsy. Management includes praziquantel and corticosteroids, with supportive rehabilitation. Prognosis depends on timely intervention, and long-term sequelae are common. Neuroschistosomiasis remains a neglected yet important cause of neurological disease in endemic areas and among travelers. Enhanced clinical awareness, improved diagnostics, and coordinated public health interventions are crucial to reduce morbidity and improve outcomes. Further research into pathogenesis and vaccine development is urgently needed.