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Current and past literature is predominantly limited to acute manifestations of NAS, and mention of chronic, ongoing clinical symptoms is usually limited to brief notes in a discussion of severe cases. This study investigated the long-term outcomes in ten individuals who were diagnosed with acute neuroangiostrongyliasis in Hawaii between 2009 and 2017. The study demonstrates a significant number of persons in Hawaii sustain residual symptoms for many years, including troublesome sensory paresthesia (abnormal spontaneous sensations of skin experienced as \u2018burning, pricking, pins and needles\u2019; also described as allodynia or hyperesthesia) and extremity muscle pains. As a consequence, employment and economic hardships, domestic relocations, and psychological impairments affecting personal relationships occurred. The study summarizes common features of chronic disease, sensory paresthesia and hyperesthesia, diffuse muscular pain, insomnia, and accompanying emotional distress; highlights the frequently unsuccessful endeavours of individuals struggling to find effective treatment; proposes pathogenic mechanisms responsible for prolonged illness including possible reasons for differences in disease presentation in Hawaii compared to Southeast Asia.<\/jats:p>","DOI":"10.1017\/s0031182020001651","type":"journal-article","created":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T08:06:59Z","timestamp":1599725219000},"page":"221-226","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["Chronic neuroangiostrongyliasis: case study of chronic presentations in Hawaii"],"prefix":"10.1017","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0215-8031","authenticated-orcid":false,"given":"Bernard C.","family":"Meyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,9,10]]},"reference":[{"key":"S0031182020001651_ref9","doi-asserted-by":"publisher","DOI":"10.2984\/1534-6188(2007)61[457:DOPCMP]2.0.CO;2"},{"key":"S0031182020001651_ref5","first-page":"11","article-title":"New records of Clausiliidae: Tauphaedusa Tau (Boettger, 1877) (Gastropoda: Heterobranchia) on O\u2018ahu, Hawaiian Islands, and the first global record of infection of a clausiliid land snail with Angiostrongylus cantonensis (Chen, 1935), the rat lungworm","volume":"126","author":"Cowie","year":"2019","journal-title":"Bishop Museum Occasional Papers"},{"key":"S0031182020001651_ref42","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2014.10.002"},{"key":"S0031182020001651_ref11","doi-asserted-by":"publisher","DOI":"10.1021\/acschemneuro.7b00299"},{"key":"S0031182020001651_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2011.01.034"},{"key":"S0031182020001651_ref44","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(08)70229-9"},{"key":"S0031182020001651_ref13","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.19-0280"},{"key":"S0031182020001651_ref22","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.17-0206"},{"key":"S0031182020001651_ref12","article-title":"Sacral myeloradiculitis (Elsberg syndrome) secondary to eosinophilic meningitis caused by Angiostrongylus cantonensis","author":"Hsu","year":"2009","journal-title":"British Medical Journal Case Reports"},{"key":"S0031182020001651_ref19","doi-asserted-by":"publisher","DOI":"10.3201\/eid1401.061529"},{"key":"S0031182020001651_ref40","doi-asserted-by":"publisher","DOI":"10.3201\/eid1110.041338"},{"key":"S0031182020001651_ref29","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1969.18.206"},{"key":"S0031182020001651_ref41","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0000368"},{"key":"S0031182020001651_ref7","doi-asserted-by":"publisher","DOI":"10.3201\/eid1311.070367"},{"key":"S0031182020001651_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-196880-9.50008-7"},{"key":"S0031182020001651_ref24","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.00546-10"},{"key":"S0031182020001651_ref10","first-page":"139","article-title":"Parasitic meningo-encephalitis in Hawaii. 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