Neurocysticercosis

Neurocysticercosis-induced hemiballismus in a child

Neurocysticercosis lesions can occur in the basal ganglia, but most of these are clinically silent. Neurocysticercosis manifesting as movement disorders is extremely uncommon. The authors report a case of neurocysticercosis in an 11-year-old girl presenting with right hemiballismus (a clinical manifestation not yet reported). Magnetic resonance imaging of the brain confirmed the solitary neurocysticercosis lesion in the left thalamus. The child was symptomatic for 5 years and improved dramatically within 2 days of starting definitive therapy for neurocysticercosis (albendazole and prednisolone).

Resolution of arterial stenosis in a patient with periarterial neurocysticercosis treated with oral prednisone

Neurocysticercosis is the most common parasitic infection of the central nervous system. Neurovascular complications have been recognized as a frequent complication, with up to 10% of strokes in endemic areas being secondary to neurocysticercosis. We report a case of acute transient left hemichorea in an 11-year-old boy with cerebral cysticercosis involving the right middle cerebral artery. Brain magnetic resonance imaging (MRI) revealed T(2)-weighted hyperintensity and gadolinium enhancement in the area surrounding the M1 segment of the right middle cerebral artery. Magnetic resonance angiography showed severe narrowing of the vessel at this site acutely. After treatment with a 1-month course of oral prednisone and initiation of aspirin, our patient had no recurrence of abnormal movements and follow-up magnetic resonance angiography and transcranial Doppler ultrasonography showed resolution of stenosis of the M1 segment.

Cerebral mass in a 13-year-old girl following long-term sojourn in the Tropics

Cysticercosis of the central nervous system is the main cause of late-onset epilepsy in tropical countries. The case of a 13-year-old German girl with a generalized seizure following long-term sojourns in the Tropics is reported. Cranial imaging showed two cerebral lesions with central calcifications. Serological, molecular and cultural examination of cerebrospinal fluid and blood was negative for various parasites, fungi and bacteria including mycobacteria. Histopathological examination after neurosurgical resection revealed calcareous bodies pathognomonic for platyhelminths, in particular tapeworms. Taken together, the radiological and histopathological findings indicate infection with cysticerci, the larvae of Taenia solium.

Emerging parasitic infections

Parasitic infections are felt by most individuals to have little impact on the health and well being of most inhabitants of Canada, Western Europe, and the United States. As the authors show in this article, parasites are always "emerging" somewhere and have a significant impact on those areas of the world. Moreover, as we are becoming an ever-smaller global village, catastrophes and instability in the Third World affect control of parasitic diseases endemic to those areas, ensuring greater chances of transmission to visitors there. The foundation of successful limitation of parasitic diseases in both developing and developed regions is still accurate and rapid diagnosis.