Dr Vineet Saggar is an alumnus of D.A.V college Chandigarh sec-10.After his MBBS from Maulana Azad Medical College (M.A.M.C) New Delhi in 2002 , he did his Post Graduation in General Surgery from Safdarjung Hospital (2002-2005). He went for his training in MCh Neuro Surgery at S.M.S Medical College Jaipur. At Jaipur he got the privilege of working with one of the pillars of Spinal Surgery -Prof. R.S. Mittal under whom he trained for almost 2yrs. After completing his MCh in July 2009, he trained under Prof. S.R. Dharker one of the pioneers of Micro- Vascular Neurosurgery in Rajasthan and India. During this time he also assisted Dr S.K Basandani another eminent Spinal Surgeon at Jaipur. Before joining Ivy Hospital as consultant Neuro Spinal Surgeon, he headed Department of Neurosurgery at Adesh Medical College Bathinda for some time. He has special interest in Spinal Surgery and Skull-Based Micro Neurosurgery. Apart from many national and international publications on Spine Surgeries, he also has research publications on Head Injury to his credit .

1. Isolated Orbital Myocysticercosis
Pooja Shadangi Saggar (M.B.B.S), Resident ,Okay
Dagnostic and Research center , Jaipur.
Email;Pooja_shadangi@yahoo.co.in.
Vineet Saggar(,Mch Neurosurgery), Consultant
Neurosurgeon IVY group of Hospitals
, Mohali.E-mail; memymyselfus@yahoo.co.in..
R.S. Mittal, Professor and Head of Department
Neurosurgery, S.M.S Medical College Jaipur.

2. • A 28 year old vegetarian male presented in out patient
department with complaints of retro-orbital pain and
swelling around right eye. He also had diplopia more
pronounced on looking down towards left side
• Fig A FIG B Fig C

3. Legends of figures
FIG A FIG B FIG C
• Fig A: Coronal T1 weighted image showing cystic
lesion in superior rectus muscle which is isointense
with hypointense nodule in its wall.
• Fig B: Saggital T 1 weighted image showing
hypointense cystic lesion in belly of sup rectus muscle
• Fig C: Cyst is hyperintense on T-2 weighted images
visible on coronal images

4. Diagnosis: Orbital Myocysticercosis
• Cysticercosis is caused by larval form of Taenia Solium. The commonest pattern of
systemic involvement is seen as neurocysticercosis and appears as a space occupying
intracranial lesion.
• Intraocular infections by Cysticercus cellulosae are more common compared to ocular
adnexal involvement.The cysts may be located in descending order of
frequency, subretinal (35%), vitreous(22%), conjunctiva (22%), anterior segment (5%)
and orbit(1%)
• Clinical features: Signs and symptoms at presentation are periocular swelling
, ptosis, ocular motility restriction , proptosis , and diplopia.
• MRI imaging is the best method of assessing patient and may confirm presence of
coexistant neuro-cysticercosis . If routine sequences do not show the intraocular cyst
clearly, a the high resolution CISS sequence may be used. Viable cysts show a
hyperintense nodule and hypointense cystic fluid on T1-weighted images. On T2-
weighted images the hypointense nodule is in contrast with the hyperintense fluid.
• D/D include orbital tumours , pseudotumours and other granulomatous inflamations of
orbit
• T/T:Orbital adnexal disease in the absence of intraocular disease is treated
medically, with Albendazole (15 mg/ kg-/day )along with oral prednisolone (1 to 1.5 mg
/kg/day for 4 weeks) (fundus examinaiton to rule out intraocular disease is must
before staring medical therapy). Intraocular disease generally requires surgical
intervention.

5. Suggested Reading
• Isolated Cysticercal Infestation of ExtraocularMuscles: CT and MR Findings.Meher
A. Ursekar, Darab K. Dastur, Daya K. Manghani, and Atul T. Ursekar.Am J
Neuroradiol 19:109 –113, January 1998
• Suss RA, Maravilla KR, Thompson J. MR imaging of intracranial cysticercosis:
comparison with CT and anatomorphologic features. AJNR Am J Neuroradiol
1986;7:235–242