Reversible parkinsonian syndrome complicating cysticercus midbrain encephalitis

We describe a clinical picture similar to Parkinson's disease in a patient with midbrain encephalitis due to cysticercosis. The clinical, radiographic, and cerebrospinal fluid findings suggested an inflammatory reaction to a dying cyst that involved midbrain structures. The encephalopathy appeared to worsen temporarily after the institution of anticysticercus therapy. A discordance between worsening parkinsonian symptoms and improving pyramidal features was noted. Virtually a complete clinical recovery eventually ensued.