Neurocysticercosis in pregnancy

Abstract

Neurocysticercosis is an infection of the
central nervous system caused by taenia
solium. A 24 yr old P2L2 woman was referred
to us on her 7th post operative day
as post partum psychosis.She gave history
of intermittent headache, vomiting
and altered behaviour for 10 days and
one episode of seizure. She was drowsy,
moving all four limbs with exaggerated
deep tendon reflexes. Her vitals were
stable. She had elevated lymphocytes
and eosinophils her blood indices were
normal.CT brain - cerebral edema, MRI
brain - starry sky pattern and MRI thigh -
multiple hyper intense lesions. She was
given tablet albendazole 400mg twice
daily for 21 days with anti edema measures
and anti convulsants. Patient improved
with treatment. Most common
presentations of neurocysticercosis include
seizure, headache, raised intra
cranial tension, stroke, neuropsychiatric
manifestations and hydrocephalous. Diagnosis
is by CSF analysis that shows
mononuclear pleocytosis ,
oligoclonal bands and eosinophilia. Stool
examination may or may not show cysticerci.
Immunoassay , CT , MRI. Brain biopsy
can be used as a last resort. Albendazole
and praziquantel are the treatment options
available. Though neurocysticercosis
is a rare disease, it should be considered
as one of the DD in patients presenting
with seizures for the first time , even in
women during her postpartum period.