Lobe-specific neuropsychiatric manifestation of neurocysticercosis

Abstract

Neurocysticercosis (NCC), an infectious disease has got polymorphic clinical features. Neuropsychiatric manifestation of NCC is a rare presentation, always misleads the diagnosis. A 43-year-old male, nonvegetarian presented with 1-month history of visual hallucination associated with wandering, muttering to self, irritability and suicidal ideas. Onset of symptoms was sudden and progressive in nature. Mental Status Examination revealed mild cognitive impairment (MCI). Magnetic resonance imaging showed calcified lesions of size 6–7 mm in left parietal and occipital lobe in gray-white matter junction. NCC often present with neurological features of the seizure (79%) and headaches (38%). In neuropsychiatric manifestation, depression was the most common presentation. This case report has highlighted a case presenting with psychotic features, a rare phenomenon of rare neuropsychiatric manifestation of NCC. The neuropsychiatric symptoms right-sided monocular visual hallucination and the MCI were found to be related to the prominent lesions in occipito-parietal lobe of the left hemisphere. Lobar-specific neuropsychiatric manifestation can be a presenting feature of NCC without any common neurological symptoms.

Keywords

• mild cognitive impairment
• neurocysticercosis
• occipital lobe
• visual hallucination