Creepy crawling creature: A case of neurocysticercosis in a 19 year old male presenting as seizure

World Congress on Neuroscience and Epilepsy

November 16-17, 2018 Tokyo, Japan

Richelyn V Yosores-Espenida and Ruben Dela Cruz

Adventist Medical Center Manila, Philippines

Posters & Accepted Abstracts: J Neurol Disord

Abstract :

A case of 19 y/o Indian male, working in Australia who was admitted due to recurrent episodes of right hand paresthesia and involuntary right hand contractions lasting for about 40 seconds then patient loss his consciousness without associated nausea, vomiting nor fever. The same incident recurred one week prior to admission which sought him consult in a nearby hospital with findings of minimal left peri-orbital hematoma due to trauma from fall after he had lost consciousness but with normal neurologic examination finding. Series of blood tests were done which revealed normal. Patient decided to come back to the Philippines where his parents are. Hence this admission and further work up. Patient is fond of eating pork barbecue and siomai but past medical history is unremarkable with no history of seizure nor epilepsy. General physical and neurologic examinations were unremarkable. Cranial MRI with contrast revealed rim enhancing cystic lesion in the region of the left precentral gyrus with moderate peri-lesion edema suggestive of an infectious/parasitic or inflammatory process. MR spectroscopy confirmed the presence of central filling defect which may represent a scolex within the lesion. EEG and stool examination were normal and negative for taenia solium, respectively. Based on MRI/MRS result despite negative fecalysis for tanea solium, diagnosis of neurocysticercosis was considered. Albendazole 600 mg/tab, 1 ½ tablet daily for 1 month, Oxcarbazepine 300 mg twice a day and Dexamethasone 5 mg/tab twice a day were started. The patient was discharged improved with no recurrence of focal seizures. Although the disease in not endemic in the Philippines, the presence of various communities of foreigners from areas where cysticercosis is prevalent implies the need to have a high index of suspicion in an appropriate clinical context. Radiologic features establish the diagnosis in the majority of cases. Prognosis is very good.

Biography :

E-mail: sweetrichyosores@yahoo.com