Chad M Miller1, Paul M Vespa. 1. Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 6236 B, Los Angeles, CA 90095, USA. chadmiller@mednet.ucla.edu.
Abstract
OBJECTIVE: We discuss the case of a 24-year-old male with severe racemose neurocysticercosis. CLINICAL FEATURES: The patient presented from an outside hospital with 4 months duration of intermittent syncope and a dull occipital headache with greatest severity in the morning. He was noted to have left facial numbness and blurred vision confined to his left eye. Magnetic resonance imaging (MRI) discovered multiple grape-like cystic structures throughout the subarachnoid space and frontal parenchyma consistent with neurocysticercosis. Additional testing revealed radiologic and culture evidence of active pulmonary tuberculosis. INTERVENTIONS AND OUTCOME: The patient was admitted to the neurocritical care unit and begun on IV corticosteroids, albendazole, and 4-drug RIPE therapy. Improvement in headache, facial numbness, and nausea were noted over the course of 1 week. Visual acuity remained impaired; however, no further episodes of syncope or deterioration were noted. CONCLUSION: Effective management of severe racemose neurocysticercosis requires appropriate diagnostic considerations, monitoring, and therapeutics well suited to a comprehensive neurocritical care unit.
OBJECTIVE: We discuss the case of a 24-year-old male with severe racemose neurocysticercosis. CLINICAL FEATURES: The patient presented from an outside hospital with 4 months duration of intermittent syncope and a dull occipital headache with greatest severity in the morning. He was noted to have left facial numbness and blurred vision confined to his left eye. Magnetic resonance imaging (MRI) discovered multiple grape-like cystic structures throughout the subarachnoid space and frontal parenchyma consistent with neurocysticercosis. Additional testing revealed radiologic and culture evidence of active pulmonary tuberculosis. INTERVENTIONS AND OUTCOME: The patient was admitted to the neurocritical care unit and begun on IV corticosteroids, albendazole, and 4-drug RIPE therapy. Improvement in headache, facial numbness, and nausea were noted over the course of 1 week. Visual acuity remained impaired; however, no further episodes of syncope or deterioration were noted. CONCLUSION: Effective management of severe racemose neurocysticercosis requires appropriate diagnostic considerations, monitoring, and therapeutics well suited to a comprehensive neurocritical care unit.
Authors: O H Del Brutto; V Rajshekhar; A C White; V C Tsang; T E Nash; O M Takayanagui; P M Schantz; C A Evans; A Flisser; D Correa; D Botero; J C Allan; E Sarti; A E Gonzalez; R H Gilman; H H García Journal: Neurology Date: 2001-07-24 Impact factor: 9.910
Authors: Hector H García; Carlton A W Evans; Theodore E Nash; Osvaldo M Takayanagui; A Clinton White; David Botero; Vedantam Rajshekhar; Victor C W Tsang; Peter M Schantz; James C Allan; Ana Flisser; Dolores Correa; Elsa Sarti; Jon S Friedland; S Manuel Martinez; Armando E Gonzalez; Robert H Gilman; Oscar H Del Brutto Journal: Clin Microbiol Rev Date: 2002-10 Impact factor: 26.132
Authors: Catherine A Cosgrove; Luiz R R Castello-Branco; Tracy Hussell; Amy Sexton; Rafaela Giemza; Richard Phillips; Andrew Williams; George E Griffin; Gordon Dougan; David J M Lewis Journal: Infect Immun Date: 2006-04 Impact factor: 3.441