UMEM Educational Pearls

Question

50 year-old with facial weakness and dysarthria. What's the diagnosis?

Answer

Stroke secondary to neurocysticercosis

Neurocysticercosis

Neurocysticercosis occurs secondary to ingestion of eggs from the Taenia solium tapeworm; ingestion typically occurs from ingestion of contaminated food.

Most patients are asymptomatic but symptoms of neurocysticercosis may include

  • Seizures (most common presentation)
  • Headache
  • Stroke
  • Neuropsychiatric dysfunction

Diagnosis is made via imaging such as CT scan; findings may vary depending on what stage of life the parasite is in (e.g., larvae); lumbar puncture should also be performed if the diagnosis is suspected.

Management should be symptomatic (e.g., seizures receive anticonvulsants) as well as eradication of the active parasites using steroids followed by albendazole (anti-parasitic drug)

References

Follow me on Twitter (@criticalcarenow) or Google+ (+criticalcarenow)