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Images in Neurology |

Cysticercotic Encephalitis Case Report of Miliary Infestation in an Encephalopathic Fashion

Luis Javier Flores Río de la Loza, MD; Elmer López Meza, MD
Arch Neurol. 2008;65(2):276-277. doi:10.1001/archneurol.2007.55.
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A 40-year-old woman was admitted to the emergency department with a history of frontal headache, no quantified fever, and a decreasing level of consciousness for the last 4 months. Neurological examination showed sleepiness, inattention, and disorientation. She did not have cranial nerve dysfunction or focal signs. Muscle strength was decreased and the tendon reflexes were increased in all 4 extremities. Babinski sign was present bilaterally. Cerebral T1-weighted magnetic resonance imaging showed multiple hypointense parenchymal (cortical, subcortical, and periventricular) lesions, which when enhanced with gadolinium acquired a ring appearance (Figures 1, 2, and 3). On T2-weighted imaging, the lesions appeared hyperintense (Figure 4). The patient was treated with 5 mg/d of oral dexamethasone for 15 days and 15 mg/kg/d of albendazole for 8 days. Clinical evolution was satisfactory, with progressive improvement of alertness and attention and no increase in intracranial pressure.

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Figure 1.

Axial T1-weighted magnetic resonance image shows multiple hypointense parenchymal lesions, which when enhanced with gadolinium acquired a ring appearance.

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Figure 2.

Coronal T1-weighted magnetic resonance image shows multiple hypointense parenchymal lesions, which when enhanced with gadolinium acquired a ring appearance.

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Figure 3.

Transversal T1-weighted magnetic resonance image shows multiple hypointense parenchymal lesions, which when enhanced with gadolinium acquired a ring appearance.

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Figure 4.

Axial T2-weighted magnetic resonance image shows multiple hyperintense parenchymal lesions in the cortical, subcortical, cortico-subcortical junction, and periventricular areas.

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