CNS involvement may occur.
CNS involvement (primary or secondary) can lead to seizures, incoordination and paralysis.
CNS involvement (confusion without any focal neurological findings)
Asian optic-spinal MS - this variant can present CNS involvement like MS.
Early recognition and treatment of CNS involvement may result in reduced neurologic impairment.
Patients with diffuse small noncleaved-cell/Burkitt lymphoma have a 20% to 30% lifetime risk of CNS involvement.
Most patients with CNS involvement develop nonparalytic aseptic meningitis, with symptoms of headache, neck, back, abdominal and extremity pain, fever, vomiting, lethargy, and irritability.
In children, nonparalytic meningitis is the most likely consequence of CNS involvement, and paralysis occurs in only one in 1000 cases.
Nifurtimox has also been used to treat African trypanosomiasis (sleeping sickness), and is active in the second stage of the disease (CNS involvement).
In many clinical settings, pediatric cases presenting with CNS involvement are routinely screened for herpes or enteroviral etiologies.