Distinctive MRI findings in a case of neurocysticercosis.

Med J Aust · 1993

case_report · Level V

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Abstract

OBJECTIVE: To report a case of cerebral neurocysticercosis, in which cranial magnetic resonance imaging (MRI) was performed at the time of probable death of the cysticercus. CLINICAL FEATURES: A 15-year-old Indian boy with a focal seizure disorder presented with a low-grade fever and an increase in seizure frequency. Cranial MRI scanning demonstrated a small, cortically based nodule surrounded by a low-intensity ring and extensive oedema. INTERVENTION AND OUTCOME: Carbamazepine therapy was continued (without steroids) and a further MRI scan after one month showed resolution of the oedema, and a subsequent cranial CT scan showed calcification of the cortically based nodule. Praziquantel therapy was administered. CONCLUSIONS: Diagnosis of neurocysticercosis must often rely upon clinical and distinctive radiological findings. Death of the cysticercus may provoke an inflammatory reaction that may result in an increase in seizure frequency.