A 36-year-old man presented with altered behavior of 3 months’ duration with recent onset of headache and seizures. Neurologic examination revealed features of raised intracranial pressure. MRI of the brain demonstrated multiple small parenchymal cystic lesions, some with scolex (figure, A, thick arrow), and with variable perilesional edema on T2-weighted studies. There were also multiple cysts in the temporalis muscles bilaterally (figure, A, thin arrows) and also in the thigh muscles (figure, B). Patient was from an area endemic for cysticercosis. Neurocysticercosis is a common parasitic infestation in developing countries and both the clinical and MRI diagnostic criteria are well established.1,2
Figure. (A) T2-weighted axial Fast Spin Echo (FSE) shows cerebral parenchyma studded with cysticercal cysts, some with scolex (thick arrow). Note also the multiple cysts in the temporalis muscles (thin arrows). (B) T2-weighted coronal FSE through the thigh shows muscles studded with the parasitic cysts.
Footnotes
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Disclosure: The authors report no conflicts of interest.
References
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