A Classic Neurocysticercosis Case with an Unusual Complication

Eur J Case Rep Intern Med. 2018 Jan 31;5(1):000762. doi: 10.12890/2017_000762. eCollection 2018.

Abstract

Cysticercosis is triggered by infection with the larval form of the tapeworm Taenia solium. The usual sites for the development of cyscticerci are the central nervous system (neurocysticercosis - NCC), subcutaneous tissue, skeletal muscle, heart muscle, and the eye. Ocular cysticercosis is caused by the growth of the larvae within ocular tissues. The extraocular muscles form is the most common type of orbital cysticercosis. We report a case of a patient admitted with seizures secondary to NCC, who developed ocular symptoms after starting combined treatment with albendazole, praziquantel and dexamethasone. The investigation revealed a cystic lesion in the lateral rectus muscle.

Learning points: Neurocysticercosis (NCC) is the main cause of epilepsy in someone coming from an endemic area; therefore, it is imperative to have a high index of suspicion.Ocular cysticercosis can present at the time of diagnosis or can be triggered by the cysticidal treatment.Before starting cysticidal treatment, systemic corticosteroid should be used in order to reduce the inflammatory response secondary to the release of toxins following the death of the parasite.

Keywords: orbit; Neurocysticercosis (NCC); Taenia solium; dexamethasone; extraocular muscles.