Isolated spinal neurocysticercosis with clinical pleomorphism

Neurocysticercosis, involvement of the central nervous system by taenia solium, is one of the most common parasitic diseases worldwide. However, isolated spinal involvement by neurocysticercosis, either intramedullary or extramedullary, is uncommon. The authors report a case of C1-C2 intradural extramedullary neurocysticercosis in a young male that presented initially with signs of raised intracranial pressure followed by high cervical myelopathy. Transventricular migration of the neurocysticercal cyst along the cerebrospinal pathways leading to clinical pleomorphism as described by the authors can perplex the best of clinicians leading to a missed diagnosis as in the present case. Diagnosis was confirmed after surgical excision and the patient is doing well at six months follow up with no neurological deficits. Spinal neurocysticercosis should be considered in the differential diagnosis in high-risk populations with new symptoms suggestive of a spinal mass lesion.