Abstract
Background: Cysticercosis, due to the parasite Taenia solium, can involve any organ. When central nervous system infection occurs, signs and symptoms depend on the location of the cerebral lesions. Most patients develop seizures, focal symptoms, or headaches with nausea and vomiting.
Case: A case of extraparenchymal (intraventricular) cysticercosis was diagnosed in a patient at term who presented with acute alteration in mental status. Ventriculostomy was performed because of acute obstructive hydrocephalus. Labor ensued and was augmented with oxytocin. Intrapartum management included magnesium sulfate seizure prophylaxis and corticosteroids. Intracranial pressures ranged between 4 and 12 cm H2O peripartum with approximately 300 mL of cerebrospinal fluid drained over the first 24 hours. Postpartum management included craniotomy with resection of a larval cyst and oral praziquantel therapy.
Conclusion: This case describes an uncommon presentation of neurocysticercosis that should be considered in gravidas with acute mental status changes.
Full Text
The Full Text of this article is available as a PDF (500.8 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bandres J. C., White A. C., Jr, Samo T., Murphy E. C., Harris R. L. Extraparenchymal neurocysticercosis: report of five cases and review of management. Clin Infect Dis. 1992 Nov;15(5):799–811. doi: 10.1093/clind/15.5.799. [DOI] [PubMed] [Google Scholar]
- Barkovich A. J., Citrin C. M., Klara P., Wippold F. J., Kattah J. Magnetic resonance imaging of cysticercosis. West J Med. 1986 Nov;145(5):687–690. [PMC free article] [PubMed] [Google Scholar]
- Bazley W. S. Maternal mortality due to cysticercus cerebri. A case report. Obstet Gynecol. 1972 Mar;39(3):362–367. [PubMed] [Google Scholar]
- Brown C. E., Purdy P., Cunningham F. G. Head computed tomographic scans in women with eclampsia. Am J Obstet Gynecol. 1988 Oct;159(4):915–920. doi: 10.1016/s0002-9378(88)80170-4. [DOI] [PubMed] [Google Scholar]
- Del Brutto O. H., Sotelo J. Neurocysticercosis: an update. Rev Infect Dis. 1988 Nov-Dec;10(6):1075–1087. doi: 10.1093/clinids/10.6.1075. [DOI] [PubMed] [Google Scholar]
- Escobedo F., Penagos P., Rodriguez J., Sotelo J. Albendazole therapy for neurocysticercosis. Arch Intern Med. 1987 Apr;147(4):738–741. [PubMed] [Google Scholar]
- Garcia H. H., Martinez M., Gilman R., Herrera G., Tsang V. C., Pilcher J. B., Diaz F., Verastegui M., Gallo C., Porras M. Diagnosis of cysticercosis in endemic regions. The Cysticercosis Working Group in Peru. Lancet. 1991 Aug 31;338(8766):549–551. [PMC free article] [PubMed] [Google Scholar]
- Ramos O. M., Stiebel-Chin G., Altman N., Duchowny M. Diagnosis of neurocysticercosis by magnetic resonance imaging. Pediatr Infect Dis. 1986 Jul-Aug;5(4):470–473. doi: 10.1097/00006454-198607000-00019. [DOI] [PubMed] [Google Scholar]
- Sotelo J., Escobedo F., Rodriguez-Carbajal J., Torres B., Rubio-Donnadieu F. Therapy of parenchymal brain cysticercosis with praziquantel. N Engl J Med. 1984 Apr 19;310(16):1001–1007. doi: 10.1056/NEJM198404193101601. [DOI] [PubMed] [Google Scholar]
- Suss R. A., Maravilla K. R., Thompson J. MR imaging of intracranial cysticercosis: comparison with CT and anatomopathologic features. AJNR Am J Neuroradiol. 1986 Mar-Apr;7(2):235–242. [PMC free article] [PubMed] [Google Scholar]
- Vazquez V., Sotelo J. The course of seizures after treatment for cerebral cysticercosis. N Engl J Med. 1992 Sep 3;327(10):696–701. doi: 10.1056/NEJM199209033271005. [DOI] [PubMed] [Google Scholar]