[A case of mixed (parenchymatous meningo-basal) neurocysticercosis]

Cysticerosis is the commonest parasitic disease to affect the central nervous system (CNS). Distribution is universal. It is endemic in many developing countries and in the Third World. CNS cysticercoses or neurocysticercosis may be classified according to its site in three main groups: parenchymatous, extra-parenchymatous and mixed. The clinical features vary from casual findings to fulminating encephalitis. The commonest presenting symptoms are intracranial hypertension (HIC) in the extra-parenchymatous forms and convulsions in the parenchymatous forms.

We present the case of an eight-year-old Peruvian boy with the clinical features of progressive intracranial hypertension. Cerebro-spinal fluid (CSF) serological and neuro-imaging findings were compatible with mixed neurocysticercosis (parenchymatous calcifications and an active meningobasal lesion). We also describe the neuro-radiological changes seen in the course of the illness of our patient after treatment with albendazol. These are mainly the reduction in size and progressive calcification of the active meningobasal lesion.

We propose a neuro-radiological classification based on that of Carpio et al as a method of helping to decide on anti-parasitic treatment. We emphasize the importance of the findings on cranial magnetic resonance (MR), using gadolinium to differentiate the various stages of the disease. Finally, we draw attention to the possible increase in this disease in our environment, due to the current increase in migration from endemic areas of Latin America.