Neurocysticercosis causing bilateral Optic Atrophy - A Case Report

Neurocysticercosis (NCC) being the most common parasitic infection of central nervous system, can also be a cause of severe visual loss. This is a case of a young man who presented with signs of raised intracranial tension being treated with albendazole and steroids. His vision in both eyes was 66 J1 with papilledema. He had multiple cysts in the brain and bilateral orbits. Albendazole was stopped and he was kept only on anticonvulsants and antiedema measures. Over an 8 month period, he progressively worsened to have cysticercal encephalitis .He had profound visual loss with secondary optic atrophy in both eyes. Patient refused to undergo an optic nerve sheath decompression. Thus prompt diagnosis and management is needed in NCC to save vision. Antihelminthic therapy should be avoided when there are multiple cysts as it will mount an intense immune response, causing raised intracranial tension and visual loss due to secondary optic atrophy. But antihelminthics under steroid cover, have been shown to be effective when the parasitic load is less.NCC being a preventable disease, various measures can be undertaken to eradicate the disease especially in endemic areas.