Spinal Neurocysticercosis: A Case Report

Abstract

Introduction Neurocysticercosis (NCC) is the most common parasitic infection of the central nervous system. In endemic areas, the incidence of the NCC was approximately 4% of the general population. Although cerebral NCC is common, only 1 to 5% of cases demonstrate the involvement of the spinal canal. Great neurological morbidity can occur if spinal NCC is not adequate and opportunely. Patient and Methods: Male 70 years’ old, with a history of cerebral NCC confirmed, DVP carrier, comes to our hospital emergency, with time of 5 months’ duration disease, begins with paresthesias in the lower limbs, progressive loss of sphincter control, decreased strength in members inferiors difficult ambulation to prevent it. On admission, the patient lucid, sensitive level D6, paraplegia, hyperreflexia in the lower limbs, and sphincters unchecked. Dorsal spine MRI shows cystic lesion of 22 × 11 × 8 mm at D5 intradural extramedullary back and left side, which determines medullar compression. Surgery is performed consisting of laminectomy and partial D4, D5, D6, and more microsurgical resection of multiple cysts. Results Histopathological examination confirmed cysticercosis. Patient in postoperatorio is stable but unchanged in neurologic status despite the images confirmed decompression. Patient’s motor weakness in the lower extremities and urinary function did not improve. Conclusion Spinal NCC can occur through direct hematogenous dissemination from the gastrointestinal tract. Spinal NCC may also be shown through the circulation of CSF. Doctors treating spinal cysts with an unusual clinical course should include cysticercosis as a differential diagnosis. MRI with contrast is recommended ELISA serum study in the diagnosis of these cases. Although spinal NCC is relatively rare, representing a distinct clinical entity that can have devastating consequences for the patient. Because of the limited size of the spinal canal, the effect of the mass of these lesions is not well tolerated.