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Inflammatory Arteriopathies and Pure Motor Hemiplegia

Oscar Del Brutto, MD; Fernando Barinagarrementeria, MD
Arch Neurol. 1989;46(4):361-361. doi:10.1001/archneur.1989.00520400015009
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To the Editor.  —We have read with interest the article by Johns et al1 on meningovascular neurosyphilis and pure motor hemiplegia. While we found the information of value since it increases our knowledge about the causes of this lacunar syndrome, we think that one of the authors' statements should be reconsidered: "... among the inflammatory arteriopathies, only syphilis and tuberculosis are associated with meningitis."Cysticercosis, the most common parasitic disease of the central nervous system,2 is a well-recognized cause of both inflammatory arteriopathy and meningitis.2,3 Meningeal cysticerci usually induce subacute, chronic, or recurrent meningitis with affection of blood vessels near the parasites. Those vessels show thickening of the adventitia with fibrosis of the media and endothelial hyperplasia3; a brain infarction may be the result of this vascular involvement.4,5 Therefore, cysticercosis should be recognized not only as a possible, but as a frequent, cause of ischemic cerebrovascular

REFERENCES

Johns DR, Tierney M, Parker SW:  Pure motor hemiplegia due to meningovascular neurosyphilis . Arch Neurol 1987;;44:1062-1065.
Escobar A. Nieto D:  Parasitic diseases , in Minckler J (ed): Pathology of the Nervous System . New York, McGraw-Hill International Book Co, 1972;, vol 3, pp 2503-2521.
Escobar A:  The pathology of neurocysticercosis , in Palacios E, Rodriguez-Carbajal J, Taveras JM (eds): Cysticercosis of the Central Nervous System . Springfield, Ill, Charles C Thomas Publisher, 1983;, pp 27-54.
Barinagarrementería F, Del Brutto OH, Otero E:  Ataxic hemiparesis from cysticercosis . Arch Neurol 1988;;48:246.
McCormick GF, Giannotta S, Zee CS, et al:  Carotid occlusion in cysticercosis . Neurology 1983;;33:1078-1080.
Sotelo J, Guerrero V, Rubio F:  Neurocysticercosis: A new classification based on active and inactive forms . Arch Intern Med 1985;;145:442-445.
Sotelo J, Del Brutto OH: Neurocysticercosis, in Román GC (ed): Tropical Neurology: An Overview. Boca Raton, Fla, CRC Press, in press.
Richards FO, Schantz PM, Ruiz-Tiben E, et al:  Cysticercosis in Los Angeles County . JAMA 1986;;254:3444-3448.
McCormick GF, Zee CS, Heiden J:  Cysticercosis cerebri: Review of 127 cases . Arch Neurol 1982;;39:534-539.
Sotelo J, Del Brutto OH:  Therapy of neurocysticercosis . Child Nerv Syst 1987;;3:208-211.

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Johns DR, Tierney M, Parker SW:  Pure motor hemiplegia due to meningovascular neurosyphilis . Arch Neurol 1987;;44:1062-1065.
Escobar A. Nieto D:  Parasitic diseases , in Minckler J (ed): Pathology of the Nervous System . New York, McGraw-Hill International Book Co, 1972;, vol 3, pp 2503-2521.
Escobar A:  The pathology of neurocysticercosis , in Palacios E, Rodriguez-Carbajal J, Taveras JM (eds): Cysticercosis of the Central Nervous System . Springfield, Ill, Charles C Thomas Publisher, 1983;, pp 27-54.
Barinagarrementería F, Del Brutto OH, Otero E:  Ataxic hemiparesis from cysticercosis . Arch Neurol 1988;;48:246.
McCormick GF, Giannotta S, Zee CS, et al:  Carotid occlusion in cysticercosis . Neurology 1983;;33:1078-1080.
Sotelo J, Guerrero V, Rubio F:  Neurocysticercosis: A new classification based on active and inactive forms . Arch Intern Med 1985;;145:442-445.
Sotelo J, Del Brutto OH: Neurocysticercosis, in Román GC (ed): Tropical Neurology: An Overview. Boca Raton, Fla, CRC Press, in press.
Richards FO, Schantz PM, Ruiz-Tiben E, et al:  Cysticercosis in Los Angeles County . JAMA 1986;;254:3444-3448.
McCormick GF, Zee CS, Heiden J:  Cysticercosis cerebri: Review of 127 cases . Arch Neurol 1982;;39:534-539.
Sotelo J, Del Brutto OH:  Therapy of neurocysticercosis . Child Nerv Syst 1987;;3:208-211.

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