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Long-lasting undetected neurocysticercosis
Aleksandar Kostić1, Nataša Vidović2, Nataša Miladinović-Tasić3
1Clinic for Neurosurgery, Clinical Center Niš, Faculty of Medicine, University of Niš, Niš, Serbia. aleko018@yahoo.co.uk.
Journal of Infection in Developing Countries
|February 8, 2020
Summary
Neurocysticercosis, a parasitic nervous system disease, can be missed for decades, especially in low-endemic areas. This case highlights the importance of timely diagnosis and combined treatment for improved patient outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Parasitology
Background:
- Neurocysticercosis is the most prevalent parasitic infection of the central nervous system.
- It often remains undiagnosed, particularly in non-endemic regions, due to diagnostic challenges and overlooked clinical suspicion.
Observation:
- A 51-year-old male presented with a 21-year history of epilepsy of unknown origin.
- Neurological decline and headaches prompted advanced imaging (CT, MRI), serological tests (Western blot), surgery, and histopathology, confirming a missed neurocysticercosis diagnosis after two decades.
Findings:
- The patient received a four-week combined therapy of albendazole and prednisolone, alongside continued antiepileptic medication.
- Significant clinical improvement and positive changes in brain imaging were observed post-treatment.
Implications:
- This case underscores the critical need for thorough diagnostic evaluation in cases of chronic neurological disorders with unclear etiology.
- Effective management involves a combination of antiparasitic medication, anti-inflammatory drugs, and long-term seizure control.
- Early and accurate diagnosis of neurocysticercosis is essential for preventing long-term neurological sequelae and improving patient prognosis.
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