Neurocysticercosis in pregnancy: a case initially diagnosed as eclampsia

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 93; no. 5; pp. 816 - 818
• Main Authors: Suarez, Victor R, Iannucci, Thomas A
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.1999; The American College of Obstetricians and Gynecologists; Elsevier Science
• Subjects: Adult; Albendazole - therapeutic use; Anthelmintics - therapeutic use; Biological and medical sciences; Brain Diseases - diagnosis; Brain Diseases - diagnostic imaging; Brain Diseases - drug therapy; Brain Diseases - surgery; Cerebral Ventricles - parasitology; Cerebral Ventricles - surgery; Cysticercosis; Diagnosis, Differential; Diseases caused by cestodes; Eclampsia - diagnosis; Female; Helminthic diseases; Humans; Infectious diseases; Medical sciences; Neurocysticercosis - diagnosis; Neurocysticercosis - diagnostic imaging; Neurocysticercosis - drug therapy; Neurocysticercosis - surgery; Parasitic diseases; Pregnancy; Pregnancy Complications, Parasitic - diagnosis; Pregnancy Complications, Parasitic - diagnostic imaging; Pregnancy Complications, Parasitic - drug therapy; Pregnancy Complications, Parasitic - surgery; Tomography, X-Ray Computed; Ventriculoperitoneal Shunt; Human; Nervous system diseases; Cysticercosis; Pregnancy disorders; Parasitosis; Helminthiasis; Cestode disease; Pregnancy toxemia; Differential diagnostic; Cerebral disorder; Infection; Case study; Pregnancy; Central nervous system disease; Eclampsia; Female; Brain (vertebrata)
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1016/S0029-7844(98)00342-1

Background: Neurocysticercosis is an infection of the central nervous system with the pork tapeworm’s cysticercus. Case: A 21-year-old Hispanic primigravida presented at 33 weeks’ gestation with acute onset of mental status changes preceded by headaches and emesis. She was transferred comatose to our institution with a diagnosis of postictal state secondary to eclampsia. Upon arrival, the patient developed anisocoria, papilledema, posturing, and hypertension. Neuroimaging showed an intraventricular cyst. The patient was treated with ventriculostomy, induction of labor, postdelivery shunting, albendazole, and prednisone. Conclusion: Neurocysticercosis should be considered in the differential diagnosis of pregnant patients with coma and/or seizures, especially if the patient has emigrated from or traveled to an endemic area. Albendazole, with shunt procedure, is the treatment of choice for intraventricular neurocysticercosis.