CALCIFIED ACTIVE NEUROCYSTICERCOSIS


1. Left frontal calcified lesion (yellow arrow), 2. Right parietal edema (hypodensity) is also seen
CT brain (non contrast) showing right parietal calcified lesion (yellow arrow) with perilesional edema (green arrow)

Neurocysticercosis (NCC) is one of the commonest causes of symptomatic epilepsy in India and many other countries. It is caused by Taenia solium (tapeworm infection). On CT scan, signs of active (alive) worm include: 1. Perilesional edema (seen as hypodensity in plain and contrast images, 2. Enhancement of lesion (disc-like or ring like) on contrast scans, 3. Presence of scolex. Calcified lesion on CT generally indicates that the worm is inactive (dead). However, in many instances, we can see calcification and edema in the same scan. This is seen in the images above.

Treatment consists of: 1. Anti-epileptic drugs to prevent seizure recurrence, 2. Albendazole for 7-10 days (15 mg per kg body weight), 3. Steroids for 5-7 days to reduce edema.

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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