Long-lasting undetected neurocysticercosis

  • Aleksandar Kostić Clinic for Neurosurgery, Clinical Center Niš, Faculty of Medicine, University of Niš, Niš, Serbia
  • Nataša Vidović Institute for Pathology, Clinical Center Niš, Faculty of Medicine, University of Niš, Niš, Serbia
  • Nataša Miladinović-Tasić Institute for Pathology, Clinical Center Niš, Faculty of Medicine, University of Niš, Niš, Serbia
  • Jovana Kostić Department for Microbiology, Public Health Institute, Faculty of Medicine, University of Niš, Niš, Serbia
  • Vesna Nikolov Clinic for Neurosurgery, Clinical Center Niš, Faculty of Medicine, University of Niš, Niš, Serbia
  • Nebojša Stojanović Clinic for Neurosurgery, Clinical Center Niš, Faculty of Medicine, University of Niš, Niš, Serbia
  • Miljana Pavlović Institute of Anatomy, Faculty of Medicine, University of Niš, Niš, Serbia
Keywords: anticonvulsants, albendazole, immunoassay, magnetic resonance imaging, neurocysticercosis

Abstract

Neurocysticercosis is the most common parasitic disease of the nervous system, nevertheless, it can remain undetected for a long period of time, especially if it occurs in non endemic areas and regions with low-endemicity. Inadequate diagnostic procedures and lack of clinician’s dedication towards this health issue can lead to a missed diagnose.

Herein, we present a case of a 51-year-old male, with a missed diagnosis of neurocysticercosis for more than two decades. A history of epilepsy had started twenty-one years earlier and was of unclear etiology. Recently, after neurological worsening and headaches, brain computed tomography and magnet resonance imaging was performed as well as Western blot immunoassay of serum and cerebrospinal fluid, surgery, and pathohistological examination of the extracted cysts. Neurocysticercosis was confirmed. Combined therapy that consisted of albendazole and prednisolone was administered for a period of four weeks. Also, antiepileptic therapy was continued. Both clinical status and brain imaging showed the apparent improvement in the patient’s condition.

Review of the literature was implemented in the discussion that deals with proper and adequate therapy option and outcome factors in neurocysticercosis patients. Over a long period of time, the majority of patients develop seizures as the most common symptom, which requires the administration of medications. Proper diagnostic procedures and adequate combination of surgery and conservative treatment areessential.

Published
2019-01-31
How to Cite
1.
Kostić A, Vidović N, Miladinović-Tasić N, Kostić J, Nikolov V, Stojanović N, Pavlović M (2019) Long-lasting undetected neurocysticercosis. J Infect Dev Ctries 13:87-92. doi: https://doi.org/10.3855/jidc.10176
Section
Case Reports