A Case of Neurocysticercosis removed successfully surgically

Abstract

A case of cerebral cysticercosis is reported in a 22-year-old female who presented with seizure originating from the right hand. Computed tomography (CT) revealed a ring-enhance lesion with a high-density dot at the center in the left motor cortex. Magnetic resonance images (MRI) also showed ring-enhancement. The location of the motor strip containing the lesion was identified by preoperative functional MRI and intraoperative somatosensory-evoked potential recording. Intraoperative ultrasound study from the surface of the motor strip clearly demonstrated location of the lesion. A round smooth-surface cyst containing a decayed parasite was easily removed through a minimal cortical incision. The specimen disclosed characteristic cysticercus features. Postoperative examinations for screening of other visceral organs including X-rays of the extremities, abdominal CT, and serum immunological assay showed no abnormal findings. MRI taken 1 month after the surgical resection showed a disappearance of the local enhancement. Retrospectively, it was thought that cyst degeneration and inflammatory reaction following the death of the parasite had caused seizures as an initial symptom in this patient.