A 62 year old Nepalese gentleman presented with left sided weakness and sensory loss. Initial brain CT scanning was suggestive of acute infarction but a subsequent MRI scan showed cysts with oedema. Cysticercosis serology was positive and a diagnosis of neurocysticercosis was made. The patient made almost a complete recovery after treatment with albendazole, praziquantel and steroids. Neurocysticercosis should be considered in the differential diagnosis when patients originating from endemic areas present with focal neurological deficit.
[download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]
References
- Héctor H García, Armando E Gonzalez, et al and Cysticercosis Working Group in Peru. Taenia solium cysticercosis. Lancet. 2003 August 16; 362(9383): 547–556. doi:10.1016/S0140-6736(03)14117–7
- Rice B, Perera P. Intramedullary spinal Neurocysticercosis presenting as Brown-Sequard syndrome. West J Emerg Med 2012;13(5): 434–6.
- Suri A, Goel RK, Ahmad FU, et al. “Transventricular, transaqueductal scope-in-scope endoscopic excision of fourth ventricular neurocysticercosis: a series of 13 cases and a review.” Emerg Radiol. 1 (1): 35–9.
- Patel R, Jha S, Yadev RK. Pleomorphism of the clinical manifestations of neurocysticercosis. Transactions of the Royal Society of Tropical Medicine and Hygiene 2006; 100: 134–41.
- Wadley JP, Shakir RA, Rice Edwards JM. Experience with Neurocysticercosis in the UK: correct diagnosis and neurosurgical management of the small enhancing brain lesion. Br J Neurosurg. 2000; 14(3): 211–8
- Jha S, Kumar V. Neurocysticercosis presenting as stroke. Neurol India 2000; 48(4): 391–4
- Wraige E, Graham J, Robb SA, et al. J Child Neurol. 2003; 18(4): 298–300. Neurocysticercosis masquerading as a cerebral infarct. J Child Neurol. 2008; 23(3): 334–7. doi:10.1177/0883073807309240. Epub 2008 Jan 11. Sudden-onset ptosis caused by midbrain neurocysticercosis in 2 children. Singhi P1 , Mahajan V, Khandelwal NK.
- Acute bilateral ptosis as the sole manifestation of neurocysticercosis in a child. Pinto S, Prata F, Moreno T. Pediatr Neurol. 2013; 49(6): 518–9. doi: 10.1016/j.pediatrneurol.2013.06.013. Epub 2013 Aug
- Sahu R1, Garg RK, Malhotra HS, et al. BMJ Case Rep. 2012 Sep 24; 2012. pii: bcr2012006795. doi: 10.1136/bcr-2012-006795. Spastic foot-drop as an isolated manifestation of neurocysticercosis.
- Chotmongkol V1, Sawanyawisuth K, Limpawattana P, Phuphatham A, et al. Superior divisional oculomotor nerve palsy caused by midbrain neurocysticercosis. Parasitol Int. 2006; 55(3): 223–5. Epub 2006 Jun 5.
- Singh NN, Verma R, Pankaj BK, et al. Neurocysticercosis presenting as Weber’s syndrome. Neurol India. 2003; 51(4): 551-2.
- Del Brutto OH, Rajshekhar V, White AC Jr, et al. Proposed diagnostic criteria for neurocysticercosis. Neurology. 2001; 57(2): 177–83.
- Marquez JM, Arauz A. Cerebrovascular complications of neurocysticercosis. Neurologist 2012; 18: 17–22.
- Bang OY, Heo JH, Choi SA, Kim DI. Large cerebral infarction during praziquantel therapy in neurocysticercosis. Stroke 1997; 28: 211–3.
- Viola GM, White AC, Serpa JA. Haemorrhagic cerebrovascular events and neurocysticercosis: a case report and review of the literature. American Journal of Tropical Medicine and Hygiene 2011; 84:402–5.
- Wraige E, Graham J, Robb SA, et al. Neurocysticercosis masquerading as a cerebral infarct. Journal of Child Neurology 2003; 18: 298–300.
- Del Brutto OH, Roos KL, Coffey CS, et al. Meta-analysis: Cysticidal drugs for neurocysticercosis: albendazole and praziquantel. Annals of Internal Medicine 2006: 145: 43–51.
- Garcia et al. Efficacy of combined antiparasitic therapy with praziquantel and albendazole for neurocysticercosis: a doubleblind, randomised control trial. The Lancet 2014; 14(8): 687–695
- Kumwenda JJ, Mateyu G, Kampondeni S, et al. Differential diagnosis of stroke in a setting of high HIV prevalence in Blantyre, Malawi. Stroke 2005; 36: 960–64.
- Del Brutto OH, Lama J. The importance of neurocysticercosis in stroke in rural areas of a developing Latin American country. American Journal of Tropical Medicine and Hygiene 2013; doi:10.4269/ajtmh.13–0196.
