Neurocysticercosis

• Main Authors: Vaani Valerie Visuvanathan, Nalini Somawera, Koh Kwee Choy
• Format: Article
• Language: English
• Published: Academy of Family Physicians of Malaysia 2013-12-01
• Series: Malaysian Family Physician
• Subjects: neurocysticercosis; Taenia solium; wild boar meat
• Online Access: http://e-mfp.org/pdf/2013v8n3/neurocysticercosis.pdf

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.