Neurocysticercosis in a 14-year-old Nigerian: A case report and review of the literature

Abstract

Neurocysticercosis (NCC), an infection of the brain by the larval form of Taenia solium tapeworm, has been described as the most common cause of acquired adult seizure and epilepsy in regions of the world where the worm infestation is endemic. It is acquired following ingestion of raw or partially cooked pork-containing cysts of T. solium. We report the case of a 14-year-old male patient, who presented with recurrent tonic–clonic partial seizures of 3 months duration, seizures, and progressive weakness of the left limb, while being fully conscious. He had a left facioparesis of the upper motor neuron type with plastic left hemiparesis. An impression of a right frontal cortical lesion was made. The laboratory investigations as well as the chest radiograph were reported as being essentially unremarkable. The magnetic resonance image of the brain revealed a circumscribed right parietal lesion which was circumscribed. A provisional diagnosis of intracranial tumor was then made. Surgery involved an en bloc resection of a cystic right parietal mass. The gelatinous fluid contained within was submitted for cytological examination. The latter revealed the presence of a cysticercus comprising the scolex, spiral canal, and the bladder wall. A diagnosis of NCC was made, and the patient was thereafter commenced on antihelminthics. The patient made an appreciable recovery thereafter. This report is to emphasize the continued existence of this disease, the need to improve diagnostic suspicion, and skill. This report further supports the proposal to declare NCC an international reportable disease.