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An occult cause of persistent nausea and vomiting
1Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
The Journal of Emergency Medicine
|November 5, 1997
Summary
A patient experienced prolonged nausea and vomiting until neurocysticercosis was diagnosed via MRI. This highlights the importance of considering central nervous system causes for persistent gastrointestinal symptoms.
Area of Science:
- Neurology
- Infectious Diseases
- Gastroenterology
Background:
- Unexplained nausea, vomiting, and abdominal pain can lead to extensive medical evaluations.
- Diagnostic challenges arise when symptoms are intermittent and initial investigations are negative.
Observation:
- A patient presented with recurrent episodes of nausea, vomiting, and abdominal pain over multiple healthcare visits.
- Initial diagnostic workups, including head computed-assisted tomography (CT) scans, did not identify the cause of the symptoms.
Findings:
- The patient's condition was finally diagnosed as active neurocysticercosis after a head magnetic resonance imaging (MRI) scan during her 13th hospital admission.
- Neurocysticercosis, a parasitic infection of the central nervous system, was the underlying etiology for the patient's severe gastrointestinal distress.
Implications:
- Central nervous system etiologies, such as neurocysticercosis, should be considered in the differential diagnosis of intractable nausea and vomiting.
- Even with negative head CT scans, persistent neurological symptoms warrant further advanced imaging like MRI to rule out conditions like neurocysticercosis.
- This case underscores the need for a broad diagnostic approach in complex gastrointestinal cases, especially when neurological symptoms are present or suspected.