Recurrent neurocysticercosis of the frontal lobe. Case report

Abstract

Introduction: Neurocysticercosis (NCC) is the result of ingestion of pork tapeworm eggs (Taenia solium) from an individual with taeniasis (taeniasis/cysticercosis complex). This disease causes the highest helminthic-related morbidity and mortality rates due to its deleterious effects on the central nervous system. 80% of the cases can be asymptomatic and 20% show non-specific clinical manifestations. Case presentation: The following report presents the case of a patient with headache, dromomania, intracranial hypertension syndrome, and cognition and gait impairment. A brain CT showed a right frontal subcortical cyst and bilateral frontoparietal calcified nodules. Neurocysticercosis of the frontal lobe was suspected as the main diagnosis considering the clinical manifestations, anamnesis and local epidemiology. Discussion: T. solium reinfection in the right frontal lobe was suspected in this patient due to perilesional edema, calcified nodules randomly distributed on the imaging and the information supplied by his relatives during anamnesis. Symptoms and signs of NCC depend on localization, number, dimensions, cysticercus stage (vesicular, colloidal, granular-nodular and calcified nodule), genotype and immune status of the host. Between 60 and 90% of cysticerci are mainly observed in the brain parenchyma, but other less frequent localizations include ventricles, subarachnoid space, eyes, meninges and spinal cord. Conclusions: It is important to know and educate the community about the life cycle of parasites, epidemiology, prevention measures and clinical manifestations of neurocysticercosis in order to make a timely diagnosis and administer an effective treatment.

Keywords

• Neurocysticercosis
• Taenia solium
• Frontal lobe
• Colombia