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Distinctive MRI findings in a case of neurocysticercosis
P L Silbert1, S S Gubbay, M Khangure
1Department of Neurology, Royal Perth Hospital, WA.
Objective:
To report a case of cerebral neurocysticercosis, in which cranial magnetic resonance imaging (MRI) was performed at the time of probable death of the cysticercus.
Clinical Features:
A 15-year-old Indian boy with a focal seizure disorder presented with a low-grade fever and an increase in seizure frequency. Cranial MRI scanning demonstrated a small, cortically based nodule surrounded by a low-intensity ring and extensive oedema.
Intervention And Outcome:
Carbamazepine therapy was continued (without steroids) and a further MRI scan after one month showed resolution of the oedema, and a subsequent cranial CT scan showed calcification of the cortically based nodule. Praziquantel therapy was administered.
Conclusions:
Diagnosis of neurocysticercosis must often rely upon clinical and distinctive radiological findings. Death of the cysticercus may provoke an inflammatory reaction that may result in an increase in seizure frequency.
Insights
Cerebral neurocysticercosis diagnosis relies on imaging. The death of a cysticercus can cause inflammation and increased seizures, as seen in this case report.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Neurocysticercosis is a significant cause of epilepsy worldwide.
- Diagnosis can be challenging, often relying on clinical and imaging findings.