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The Cerebello-Extrapyramidal Form of Trypanosomiasis

Report of a Case Simulating an Abiotrophy with Post-Mortem Study

A young colored patient with a syndrome of ataxia and chorea simulating a spastic hereditary ataxia was found to have the classical cerebello-extrapyramidal form of encephalitic trypanosomiasis. The encephalitis was in the form of a systemic involvement usually associated with the true abiotrophies, namely, dentato-cerebellar, olivo-cerebellar, pyramidal, posterior column and luysipallidal degeneration. The adiposogenital syndrome with cryptorchidism seen in this patient can be found in cases of true abiotrophy. Since the testes and other endocrine glands were not available for examination, it is impossible to ascribe the endocrine disturbances to a central autonomic lesion. However, judging from the hypothalamic lesions present, it is conceivable that they may have had a role in the production of the endocrinopathy. The present case provides one more example for those investigators who insist that the genital system is highly vulnerable in sleeping sickness. It is of great theoretical interest to find that an inflammatory disease such as trypanosomiasis may, like syphilis, cause degeneration of fiber systems in such a manner that the clinical appearance becomes that of an heredodegenerative disease.