[Chronic nervous form of Chagas disease: clinical course and anatomopathology of a case followed-up for 20 years].

The chronic nervous forms of Chagas' disease involve both the central and peripheral nervous systems although they are not detected at the frequency indicated by Chagas in his initial observations. The present report concerns a patient with chronic Chagas' disease since childhood who progressively developed involvement of voluntary motility, muscle tone, coordination, and cranial nerves. The patient also had Chagas' heart and colon disease. The patient died after surgery for hemicolectomy and was autopsied. Histologic study of the central nervous system revealed demyelination of the spinocerebellar tracts and posterior columns, a great reduction in the Purkinje cells number, extensive cell loss of the substantia nigra and locus coeruleus, lacunar state in the basal nuclei, tissue infiltration by aberrant Herring bodies, porencephaly, and thickening of the meninges.