Ruchita Shah1, Subho Chakrabarti. 1. Department of Psychiatry, Post-Graduate Institute of Medical Education and Research, Chandigarh 160012, India. drruchitashah@gmail.com
Abstract
BACKGROUND: Neurocysticercosis (NCC) is the most serious form of cysticercal infection and is a major public health problem in the developing world. NCC presents with a range of psychiatric symptoms besides neurological symptoms. There have been few reports from the Asian continent describing the neuropsychiatric manifestations. Our aim was to report manifestations and treatment issues in three cases with disseminated NCC. METHODS AND RESULTS: Informed consent was obtained from all the three patients for the purpose of reporting. All three had multiple cysticerci in the brain and presented with several neuropsychiatric manifestations. All the patients had epilepsy and in addition they had varying psychiatric symptoms of delusions, hallucinations and catatonia, and cognitive symptoms. Also, interestingly in one patient, worsening of psychiatric and neurological symptoms correlated with anti-helminthic treatment. The psychotic symptoms responded to anti-psychotic treatment in one case. Anti-epileptics and steroid courses when given improved the clinical status. CONCLUSION: NCC presents with a myriad of manifestations. Epilepsy, psychotic and cognitive symptoms respond to symptomatic treatment. Use of anti-parasitic agents might worsen the symptoms as has been reported in a few cases earlier.
BACKGROUND:Neurocysticercosis (NCC) is the most serious form of cysticercal infection and is a major public health problem in the developing world. NCC presents with a range of psychiatric symptoms besides neurological symptoms. There have been few reports from the Asian continent describing the neuropsychiatric manifestations. Our aim was to report manifestations and treatment issues in three cases with disseminated NCC. METHODS AND RESULTS: Informed consent was obtained from all the three patients for the purpose of reporting. All three had multiple cysticerci in the brain and presented with several neuropsychiatric manifestations. All the patients had epilepsy and in addition they had varying psychiatric symptoms of delusions, hallucinations and catatonia, and cognitive symptoms. Also, interestingly in one patient, worsening of psychiatric and neurological symptoms correlated with anti-helminthic treatment. The psychotic symptoms responded to anti-psychotic treatment in one case. Anti-epileptics and steroid courses when given improved the clinical status. CONCLUSION: NCC presents with a myriad of manifestations. Epilepsy, psychotic and cognitive symptoms respond to symptomatic treatment. Use of anti-parasitic agents might worsen the symptoms as has been reported in a few cases earlier.