Cysticercosis, a parasitic infection of human tissue caused by Taenia solium (Pork tape worm). Cysticercosis is usually acquired by eating uncooked vegetables or not properly cooked pork meat and drinking water contaminated by tape worm eggs from human faeces. It can involve skin, eyes, muscle etc. Specifically, neurocysticercosis (NCC) means involvement of nervous tissue by this parasite causes different types of neurological symptoms. It is the most common parasitic infection in the human nervous system. In endemic areas, Japanese encephalitis is one of the most common co-infection with NCC.
Most common locations of NCC include: Brain parenchyma near grey and white matter junction, subarachnoid spaces, ventricles (m/c 4th ventricle). Very rarely the spinal cord can be involved where we can see both intramedullary or extramedullary lesion. Till 2010, only 53 cases of intramedullary spinal cord NCC had been reported. In this article we will discuss a case report of variable stages of NCC involving brain, intramedullary part of spinal cord along with Japanese encephalitis co-infection.
A 32 years old male patient presented with weakness of bilateral lower limbs, few episodes of seizure and poor GCS
In contrast enhanced MRI of brain:
Few ring enhancing lesion with surrounding edema in bilateral fronto-parietal lobes.
Also there are FLAIR hyperintensity in the bilateral thalamii, caudate nuclei and hippocampal region and showing diffusion restriction on DWI images, feautures are suggestive of Japanese encephalitis.
In contrast enhanced MRI of whole spine, we can there is a ring enhancing lesion in the intramedullary part of spinal cord i.e. conus medullaris.
Author: Dr. Jahangir Kabir
(3rd year Resident, Radiology)
(Editor: Orthopaedics Plus)
Mail: [email protected]