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Cysticercal meningoencephalitis
S Venkataraman1, A K Roy, R M Dhamija
1Neurological Centre, Army Hospital, Delhi Cantt.
Abstract:
Meningoencephalitic syndrome can be caused by many infective agents. Over a period of 13 years, 15 of 170 cases of neurocysticercosis (NCC) presented as meningoencephalitis. The basis of diagnosis of NCC was positive subcutaneous nodule histopathology (4), CT scan (9) and autopsy (3) findings. The age of the patients ranged from 7-68 years (mean 32). Fever was encountered in 12, altered sensorium in 7, seizures in 10 and abnormal behaviour in 3 cases. All cases had papilloedema. Focal neurological signs included optic atrophy, lateral rectus palsy, hemiplegia, internuclear ophthalmoplegia and cerebellar ataxia. Cerebrospinal fluid was abnormal in 8 of 13 cases, leading to a suspicion of tuberculous meningitis. Twelve patients improved with therapy. Three cases ended fatally and autopsy confirmed the diagnosis.
Insights
Neurocysticercosis (NCC) can manifest as meningoencephalitis, a serious brain inflammation. This study highlights NCC as a treatable cause of meningoencephalitis, with most patients showing improvement after therapy.
Area of Science:
- Neurology
- Infectious Diseases
- Parasitology
Background:
- Meningoencephalitis presents with diverse etiologies.
- Neurocysticercosis (NCC) is a significant parasitic infection of the central nervous system.
Purpose of the Study:
- To investigate the clinical presentation and diagnostic features of neurocysticercosis (NCC) presenting as meningoencephalitis.
- To assess the outcomes of NCC-induced meningoencephalitis.
Main Methods:
- Retrospective analysis of 170 neurocysticercosis cases over 13 years.
- Diagnosis confirmed via subcutaneous nodule histopathology, CT scans, and autopsy.
- Clinical data including symptoms, neurological signs, and cerebrospinal fluid analysis were reviewed.
Main Results:
- 15 out of 170 (8.8%) neurocysticercosis cases presented with meningoencephalitis.
- Common symptoms included fever (12), seizures (10), and altered sensorium (7).
- Papilledema was present in all cases; cerebrospinal fluid abnormalities were noted in 8/13.
Conclusions:
- Neurocysticercosis is an important, often treatable, cause of meningoencephalitis.
- Early diagnosis and appropriate therapy can lead to favorable outcomes in most patients.
- NCC should be considered in the differential diagnosis of meningoencephalitis, especially in endemic areas.