DISTINCTIVE MRI FINDINGS IN A CASE OF NEUROCYSTICERCOSIS

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. Clinic 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.