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.
Luis Javier Flores Río de la Loza, Elmer López Meza. Cysticercotic EncephalitisCase Report of Miliary Infestation in an Encephalopathic Fashion. Arch Neurol. 2008;65(2):276–277. doi:10.1001/archneurol.2007.55