| Summary: | A 19-year-old Chinese man presented with
progressive ascending weakness of his left
lower limb for 1 week. There was no loss of
sensation. His other limbs were unaffected.
He also complained of progressive, painless
blurring of vision in his left eye for the past
1 month. He has an affinity for wild boar
meat from local Chinese restaurants, which
he has been consuming on a daily basis for the
last 2 years. He denied any fever, headache,
high risk behaviour for acquisition of human
immunodeficiency virus (HIV) infection or
recent travels. He had bronchial asthma in
childhood, but the symptoms are minimal now
and there was no recent acute exacerbations.
Physical examination was unremarkable except
for the left lower limb power of 3/5 and bilateral
papilloedema on direct ophthalmoscopy. A
Contrast-enhanced computed tomography
(CECT) scan of the brain (Image 1) and
Magnetic resonance imaging (MRI) of the
brain (Images 2 and 3) were performed. The
total leucocyte count was 9.2x109
/L, C-reactive
protein was 1.2 and erythrocyte sedimentation
rate was 6 mm/h. Human immunodeficiency
virus screening was negative, anti-toxoplasma
antibodies were not detected and serological
testing for anti-cysticercal antibodies via enzymelinked
immunosorbent assay (ELISA) did not
produce a positive yield. He was treated with
oral albendazole for 28 days and corticosteroids,
which led to rapid and total resolution of his
neurological deficits and CT findings within 6
weeks.
|
|---|
