In acute schistosomiasis, which neurological finding may be present?

• A. Headache with no focal deficit
• B. Seizures
• C. Meningitis
• D. Focal neurological deficits

Answer: (D)

Neuroschistosomiasis from acute schistosomiasis typically causes localized CNS inflammation from egg deposition, leading to focal neurological symptoms. When schistosome eggs lodge in the brain or spinal cord, they trigger granulomatous granulomas that affect specific tracts or regions, producing deficits that map to the affected area—for example, weakness on one side, sensory changes in a particular region, or cranial nerve palsies depending on where the lesion sits. Seizures can occur but are less specific, and meningitis would present with diffuse meningeal signs rather than a localized deficit. Headache may accompany CNS involvement but does not localize the lesion. Therefore, focal neurological deficits best reflect the underlying pathology of neuroschistosomiasis.