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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