Extradural spinal neurocysticercosis mimicking epidural abscess: a case report

Neurocysticercosis is an infection of the central nervous system (CNS) caused by the larvae of the tapeworm Taenia solium. Spinal neurocysticercosis is a very uncommon form of neurocysticercosis, among which intradural extramedullary is the most common, intramedullary is less common, and extradural is very rare.

A 28-year-old woman presented to the center with complaints of back pain for 2 years; gradual-onset bilateral lower limb weakness associated with a loss of sensation and stiffness of the lower limbs for 2 months; intermittent fever with a maximum recorded temperature of 101 °F; and involuntary passage of urine and stool for 3 days, with no history of trauma or any other comorbidities.

Extradural spinal neurocysticercosis is a very rare form of neurocysticercosis, presenting with very vague symptoms that may mimic other infectious conditions of the spinal cord. The patient was diagnosed with an epidural abscess, underwent decompression surgery, and was treated accordingly in the initial phase, as MRI findings suggested infective pathology. However, the histological diagnosis of the tissue after surgery was suggestive of neurocysticercosis, and medical therapy for the same was then introduced, with the patient continuing rehabilitation. This multidisciplinary approach to treatment is important for the proper management of the patient.

In summary, this case highlights a rare presentation of extradural spinal neurocysticercosis. It sheds light on the diagnostic challenges and treatment, emphasizing the importance of considering neurocysticercosis in patients with spinal symptoms mimicking infective pathology.