Atypical Presentations of Extraparenchymal Neurocysticercosis

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Title Atypical Presentations of Extraparenchymal Neurocysticercosis
Creator Jason Fan; Rui Tang; Lily Zhang; Phuong T. Hoang; Folusakin Ayoade; Julio A. Diaz-Perez; Heather E. Moss; Hong Jiang
Affiliation Bascom Palmer Eye Institute (JF, LZ, HJ), Division of Infectious Disease (FA), Department of Medicine, and Department of Neurology (HJ), University of Miami Miller School of Medicine, Miami, Florida; Texas Tech University Health Sciences Center (RT), Paul L. Foster School of Medicine, El Paso, Texas; Departments of Neurology and Neurological Sciences (PTH, HEM), and Department of Ophthalmology (HEM), Stanford University, Palo Alto, California; Department of Pathology and Laboratory Medicine (JAD-P), University of Miami, Miami, Florida; and Department of Dermatology (JAD-P), University of Tennessee, Memphis, Tennessee
Abstract Background: Neurocysticercosis (NCC) is the most common parasitic infection of the central nervous system and is typically diagnosed through visualization of the cysts in the cerebral parenchyma by neuro-imaging. However, neuro-imaging may not detect extraparenchymal neurocysticercosis (EPNCC), which is a rare manifestation of the disease involving the subarachnoid, meningeal, and intraventricular spaces. We report 2 cases of extraparenchymal neurocysticercosis, and discuss the diagnostic challenges and management of this entity. Methods: Two cases were identified through clinical records. Results: Both patients had an insidious onset with slow progression of disease, and presented with papilledema and cerebrospinal fluid (CSF) eosinophilia. One case was diagnosed with spinal cord biopsy. The other was diagnosed with CSF serology and next-generation sequencing-based pathogen analysis. Both patients were treated with ventriculoperitoneal shunt, systemic antiparasitic agents, and immunosuppression. Conclusions: EPNCC is less common than parenchymal NCC. A high level of clinical suspicion is required given its rarity, long incubation period, and slow progression. Diagnosis and treatment can be challenging and requires a multidisciplinary approach.
Subject Central Nervous System / pathology; Humans; Magnetic Resonance Imaging; Neurocysticercosis / diagnosis; Subarachnoid Space; Ventriculoperitoneal Shunt
OCR Text Show
Date 2023-09
Date Digital 2023-09
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Source Journal of Neuro-Ophthalmology, September 2023, Volume 43, Issue 3
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6vnxh4f
Setname ehsl_novel_jno
ID 2538060
Reference URL https://collections.lib.utah.edu/ark:/87278/s6vnxh4f
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