Although gnathostomiasis is endemic to Asia and Latin America, almost all neurognathostomiasis cases are reported from Thailand.
We found 24 reports describing a total of 248 patients with neurognathostomiasis published in English-language literature.
With the advance of high-resolution neuroimaging, the parasitic tracks of Gnathostoma could be demonstrated on magnetic resonance imaging (MRI), aiding the diagnosis of neurognathostomiasis in the absence of worm recovery (11).
Most (241/248) identified cases of neurognathostomiasis reported in the English-language literature were from Thailand.
The first case of neurognathostomiasis in a traveler was reported in 2003 (19).
The hallmark sign of neurognathostomiasis is the evidence of multiple hemorrhagic tracks; these tracks have been documented throughout the spinal cord and brain tissue by postmortem examination (9), as well as through neuroimaging (31).
The main clinical syndromes of neurognathostomiasis are radiculomyelitis/ radiculomyeloencephalitis, meningitis/meningoencephalitis, and subarachnoid and intracerebral hemorrhage (Table 1).
However, in the largest published series of neurognathostomiasis in 162 patients, only 11 (7%) had a history of cutaneous lesions (10).
Neuroimaging of 11 patients with neurognathostomiasis was reported in English-language literature.