Gnathostomiasis is a food borne zoonosis caused by third stage larva, in which cyclops are definitive hosts and humans are accidental hosts. It is common in tropical and subtropical areas especially Southeast Asian countries. Infection in humans occurs due to the consumption of  intermediate hosts or through contaminated water. The clinical features include cutaneous form followed by visceral manifestations. The major CNS manifestations include radiculomyelitis, myeloencephalitis, eosinophilic meningitis, subarachnoid haemorrhage. The most common manifestation is spinal cord involvement (55%). Myelitis is characterised by radicular pain followed by paresis with bladder dysfunction and sensory level usually thoracic. Spinal gnathostomiasis have been reported by several authors but cerebral ring enhancing lesions are rare.

We report here 2 cases of Gnathostomiasis with different presentations. First case presented with  one-month history of fever followed by truncal paresthesias, erythematous creeping skin eruptions and paraparesis with blood and Cerebrospinal fluid eosinophilia on a background history of consuming undercooked fish. Magnetic Resonance Imaging spine showed long segment T2 hyperintensities with contrast enhancement. He was tested positive for 24kDa antigenic component of Gnathostoma spinigerum in CSF and serum by immunoblot testing.