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Case Report

Good recovery of a patient with

neurocysticercosis using two antihelminthic

drugs combined with steroid

Xin-Di Li, Hua-Bing Wang, Heng Zhou, An-Na Zhou, Lin Zhao, Yong-Hong Liu, Xiao-Qing Gong, Xing-Hu Zhang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.

Mr. Xing-Hu Zhang, MD, Professor, is Director of Neuroinfection and Neuroimmunology Center, Department of
Neurology, Beijing Tiantan Hospital, Capital Medical University, China. He is a member of Neuroimmunology Group,
Neurology Branch, Chinese Medical Association, and a member of Neuroimmunology Branch, Chinese Society of
Immunology. And also, he is a member of Editorial Board of Journal of Chinese Neuroimmunology & Neurology.

A B S T R AC T
Neurocysticercosis is the most common parasitic infection of the central nervous system. We present a case report of a neurocysticercosis
patient with multiple cysts, who presented with new onset generalized tonic-clonic seizures. A 4-cycle treatment of 2 different antihelminthic
drugs with dexamethasone and sodium valproate led to clinical improvement without any adverse reactions. The manifestations of
neurocysticercosis are protean and the diagnosis should be considered whenever multiple cysts are seen on computed tomography or
magnetic resonance imaging. The antihelminthic treatment of neurocysticercosis should be individualized, especially for patients with
multiple cysts.
Key words: Neurocysticercosis; parenchymal neurocysticercosis; neurocysticercosis diagnosis; antihelminthic drug

INTRODUCTION CASE REPORT

Neurocysticercosis has become a serious public health A 45-year-old male was brought to a local hospital with a
concern, especially in developing countries where the generalized tonic-clonic seizure which self-terminated after
prevalence rate reaches 4%. Neurocysticercosisis 2 min. Further such seizures recurred over the following 20
[1]
caused by the larval form of the tapeworm Taenia days. There was no headache, dizziness or vomiting. His
solium grow in cerebral parenchyma, ventricles and weight was 80 kg. On examination of the central nervous
subarachnoid space, and is the leading cause of system, higher mental functions were normal
acquired epilepsy. Therapeutic measures include (30/30 mini-mental state examination). All cranial
surgery, symptomatic therapy and antihelminthic nerves were intact. All muscles tone and power,
[2]
drugs such as albendazole and praziquantel. deep tendon and planter reflexes were all normal. The
Evidence supporting existing treatment guidelines for general examination was normal. The first brain magnetic
neurocysticercosis is inadequate although there has resonance imaging (MRI) [Figure 1], undertaken at the
been a comparison between the efficacy of albendazole local hospital, showed multiple large spherical viable
cysts distributed evenly throughout the brain parenchyma,
and praziquantel. [2]
that were hyperintense (with respect to brain
Corresponding Author: Dr. Xing-Hu Zhang, Department of parenchyma) on the T2-weighted scan and
Neurology, Beijing Tiantan Hospital, Capital Medical University,
No.6 Tiantanxili, Dongcheng District, Beijing 100050, China. This is an open access article distributed under the terms of the Creative
E-mail: xhzhtiantan@hotmail.com Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows
others to remix, tweak, and build upon the work non-commercially, as long as the
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www.nnjournal.net Cite this article as: Li XD, Wang HB, Zhou H, Zhou AN, Zhao L, Liu YH,
Gong XQ, Zhang XH. Good recovery of a patient with neurocysticercosis
using two antihelminthic drugs combined with steroid. Neuroimmunol
DOI: 10.20517/2347-8659.2015.51 Neuroinflammation 2016;3:120-3.
Received: 17-11-2015; Accepted: 06-03-2016

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