Neurocysticercosis in pregnancy

Neurocysticercosis is an infection of the central nervous system caused by taenia solium. A 24 yr old P2L2 woman was referred to us on her 7th post operative day as post partum psychosis.She gave history of intermittent headache, vomiting and altered behaviour for 10 days and one episode of seizure. She was drowsy, moving all four limbs with exaggerated deep tendon reflexes. Her vitals were stable. She had elevated lymphocytes and eosinophils her blood indices were normal.CT brain - cerebral edema, MRI brain - starry sky pattern and MRI thigh - multiple hyper intense lesions. She was given tablet albendazole 400mg twice daily for 21 days with anti edema measures and anti convulsants. Patient improved with treatment. Most common presentations of neurocysticercosis include seizure, headache, raised intra cranial tension, stroke, neuropsychiatric manifestations and hydrocephalous. Diagnosis is by CSF analysis that shows mononuclear pleocytosis , oligoclonal bands and eosinophilia. Stool examination may or may not show cysticerci. Immunoassay , CT , MRI. Brain biopsy can be used as a last resort. Albendazole and praziquantel are the treatment options available. Though neurocysticercosis is a rare disease, it should be considered as one of the DD in patients presenting with seizures for the first time , even in women during her postpartum period.