Neurocysticercosis in pregnancy: a case initially diagnosed as eclampsia.

Abstract

Neurocysticercosis is an infection of the central nervous system with the pork tapeworm's cysticercus. A 21-year-old Hispanic primigravida presented at 33 weeks' gestation with acute onset of mental status changes preceded by headaches and emesis. She was transferred comatose to our institution with a diagnosis of postictal state secondary to eclampsia. Upon arrival, the patient developed anisocoria, papilledema, posturing, and hypertension. Neuroimaging showed an intraventricular cyst. The patient was treated with ventriculostomy, induction of labor, postdelivery shunting, albendazole, and prednisone. Neurocysticercosis should be considered in the differential diagnosis of pregnant patients with coma and/or seizures, especially if the patient has emigrated from or traveled to an endemic area. Albendazole, with shunt procedure, is the treatment of choice for intraventricular neurocysticercosis.