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Revista de la Facultad de Medicina (México)

On-line version ISSN 2448-4865Print version ISSN 0026-1742

Abstract

MORALES-SANDOVAL, José de Jesús; TELLEZ-ARELLANO, Carlos Alejandro  and  FLEURY, Agnès. Extraparenchymal Neurocysticercosis: Therapeutic Challenge. About a Case. Rev. Fac. Med. (Méx.) [online]. 2020, vol.63, n.4, pp.19-27.  Epub Mar 05, 2021. ISSN 2448-4865.  https://doi.org/10.22201/fm.24484865e.2020.63.4.03.

Introduction:

Neurocysticercosis is a parasitosis of the central nervous system, caused by the intake of eggs from taenia solium. It has a high prevalence in certain regions of Latin America, the southeast of Asia, and sub-Saharan Africa, where unhealthy situations still prevail.

Clinical case:

A 55-year-old woman with clinical symptoms of 2 years of evolution, such as recurrent headaches that had increased recently in addition to tonic-clonic seizures. In these conditions she was admitted to the hospital’s emergency department. Neuroimaging studies (tomography and magnetic resonance imaging) showed the presence of subarachnoid vesicular structures compatible with neurocysticercosis. Therefore, a cestocidal treatment was administered but the patient did not return to her follow-up appointments for 4 years. When she finally went to her appointment, she was very symptomatic and required the administration of 8 cycles of treatment to eradicate the parasites.

Discussion:

The great heterogeneity and the non-specificity of the signs and symptoms difficult making a diagnosis of neurocysticercosis. Therefore, it is important to look for complementary laboratory and imaging evidence to confirm it. The treatment of neurocysticercosis represents a challenge for the physician. Particularly, when the parasite is located outside the brain parenchyma, subarachnoid cisterns and ventricular system. In less than a third of these patients the parasites disappear with a single cycle of cestocidal treatment.

Conclusion:

Neurocysticercosis is a disease closely related to poverty, but it is preventable. Research focused on treatments for neurocysticercosis is still necessary.

Keywords : Neurocysticercosis; taenia solium; seizures; magnetic resonance; cestocidal.

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