Neurocysticercosis diagnosed by MRI or CT brain scans. Blood tests are not always accurate – could develop antibodies for parasite, but not have the infection. Surgery can confirm diagnosis. Research article: greater that 50% of individuals diagnosed with neurocysticercosis by CT scans test negative for the disease after enzyme-linked immunoelectrotransfer blot assay (EITB) is done. This is because it is assumed that NC is main caused of symptomatic epilepsy in developing countries.
IMAGE OF THE WEEK
Dr.T. Jaya Packiam
A 16 years old boy admitted with complaints of Abnormal
movement left thumb and left eyelid more than 1 hour.
Patient takes mixed diet
General examination and systemic examination were
Routine investigations CBC LFT RFT ECG CXR were also
1.Usually larger>2CM and usually multiple Smaller<2CM,may be single or multiple
2.Associated with basal meningitis or
3.They are more common in posterior
Most commonly occur at the gray-white
4.Look for CF of tb elsewhere lungs,lymph
Look for occular involvement,muscle
involvement or subcutaneous nodules
5.T2 weighted MRI shows
scolex will be absent.
Midline shift will be present.
T2 weighted MRI shows
scolex will be present.
No Midline shift.
Isolated ring enhancement.
6.MR spectroscopy may show lipid peaks
MR spectroscope may show multiple
amino acid peaks.
MRI FINDINGS IN
T1W1 T2W2 MRI FLAIR
ISO INTENSE TO CSF.
MILDLY HYPERINTENSE TO
CSF,MILD TO MARKED
CSF,MILD TO MARKED
THICKENED RETRACTED CYST
DIFFICULT TO DETECT
• Neurocysticercosis is the most common parasitic disease
• Intraparenchymal parasitic infection caused by pork
Tapeworm Tinea solium.
• 4 pathogenic stages
• -Vesicular(larva alive)
• -colloidal vesicular(degenerating larva)
• -granular nodular(healing)
• -nodular calcified.(healed)
-parenchymal cyst often hemispheric at grey white
-Intraventricles often isolated
-Basal cisterns cysts may be racemose(Multiple Grapelike)
-Size of the cyst 1-2cm and scolex will be 1-4mm.
-Lesions may be different stages in same patient.
New onset seizures with or without generalisation
May involve brain parenchyma – seizure/FND
Subarachnoid space / Ventricular Space – May mimic
Cysticercosis can be diagnosed several
• MRI or CT brain scans
• Blood tests-ELISA
• ANTI CONVULSANT THERAPY:
CAN BE STOPPED ONCE CT SHOWS RESOLUTION
• ANTIHELMINTHIC THERAPY:
• ALBENDAZOLE 15MG/KG/DAY IN 2DOSES FOR 8DAYS
• PRAZIQUANTEL 50MG/KG/DAY TDS FOR 15 DAYS
TO REDUCE THE INFLAMMATORY RESPONSE OF