Vertigo: An Atypical Presentation of Neurocysticercosis Successfully Treated With Albendazole

A 20-year-old male presented to our facility with a worsening sensation of "the room spinning around" himself for the past three weeks. In the last week, he began to experience daily spells lasting for three hours each without losing consciousness. The patient had recently migrated from Central America six weeks prior to admission. On physical examination, his vital signs were within normal limits, with no focal neurological deficits. Magnetic resonance imaging (MRI) of the brain revealed a cystic-appearing lesion in the fourth ventricle with associated mass effect on the posterior aspect of the brainstem and mild periventricular edema. Laboratory studies were unremarkable except for a positive anti-cysticercus IgG antibody, which confirmed the diagnosis of neurocysticercosis. Initially, surgery was considered, but the neurosurgeons advised medical management due to the small size of the lesion. The patient was started on albendazole 400 mg orally twice daily and dexamethasone 6 mg orally daily for 14 days. The patient responded well; his symptoms resolved by the eighth day. He was discharged home to complete his treatment and remained asymptomatic at the follow-up appointment two weeks later.