2 Case Reports in Medicine Figure 1: Sagittal T2-weighted spinal MRI shows an intramedullar hyperintense lesion extending from T4 to T10 (between the arrows). was negative. The patient did not own domestic dogs, but multiple cats were free-living on his farm. He regularly soiled his hands while feeding hay to his cattle, and he did never wash his hands before meals. A diagnosis of Toxocara encephalomyelitis was made, and he was further treated with oral albendazole 400 mg q12h (11 mg/kg body weight) for 16 days and oral methylprednisolone starting with 64 mg q24h and slowly tapering oﬀ the dosage. He slowly recovered. About 2 months after the onset of symptoms, he could walk independently but still with slight disability. Imaging of spinal cord and brain at that time showed complete resolution of lesions (Figures 5 and 6). 3. Discussion Human toxocariasis is a zoonosis caused by infective larvae of Toxocara canis or (less often) Toxocara cati. These nematodes live as adult worms in the intestinal tract of dogs and cats, respectively. Humans are usually infected by ingestion of embryonated eggs in soil, most often on contaminated hands [1, 2]. The migration of larvae to various tissues causes pathologic and immunologic responses with granulomatous inﬂammation and eosinophilia [2–4]. Visceral involvement of the disease is called visceral larva migrans (VLM) [2]. Most Toxocara infections are probably subclinical or benign and self-limiting. The typical patients are children between the ages of 2 and 7 years with a history of geophagia and exposure to puppies or kittens at home or in public parks [1– 3]. Some experts have disputed the role of dogs as transmitter because up to half of patients do not own a pet and cannot recall any close animal contact [4]. The clinical signs of VLM are usually associated with hepatic and pulmonary larval migration and include abdominal pain, decreased appetite, restlessness, fever, coughing, wheezing, asthma, and hep- atomegaly. Infection is usually characterized by marked and chronic eosinophilia, leukocytosis, and hypergammaglobu- linemia [1–3]. In ocular larva migrans (OLM), involvement Figure 2: Axial T2-weighted brain MRI shows a large left-sided hyperintense occipital lesion. Figure 3: Sagittal FLAIR brain MRI shows a lesion cranial to the corpus callosum and the large occipital lesion. is restricted to the eye and the optic nerve. OLM typically presents as unilateral vision impairment that is sometimes accompanied by strabismus. The most serious consequence of infection is invasion of the retina, leading to granuloma formation. Blindness is a common complication [2]. Neurological manifestations of toxocariasis are rare. In the English language medical literature from 1950 to 2007, we found only 31 cases of neurological toxocari- asis in humans [1, 5, 6]. Possible clinical syndromes are encephalopathy, meningoencephalitis, transverse myeli- tis, psychiatric disturbances, focal or generalized seizures, epilepsy, and death [3]. For a brief overview of the main clinical and paraclinical data of 21 patients from 1956 until 2002, we refer to the article by Moreira-Silva et al. [7]. In literature, we have encountered only 5 previous cases of Toxocara myelitis (with MRI and positive serology in blood and CSF), all of them made a good recovery [5, 6]. Recently,