Dados do Trabalho

Título

Pseudotumoral neurocysticercosis

RESUMO

CASE PRESENTATION: Woman, 38 years old, no comorbidities, is forwarded to Neurology due to recurrent tonic-clonic seizures on the right, and secondary generalization, with sudden onset one month ago. The patient lives on a rural property, having agricultural and swine farming activities. In the examination, does not present focal signals, however, shows impairment in attention, fixation memory, and basic math operations. Image exam was realized, and brain MRI evidenced a single cystic lesion, easily identified, with 5 cm in the largest diameter, homogeneous and well delimited, with a liquor-like component in all MRI sequences, without contrast capture, in the left parietal lobe with mass effect. It was initiated carbamazepine, albendazole, and dexamethasone ,and, after, valproic acid, without modification of the condition, remaining symptomatic and with the same seizures. Parietal craniotomy was realized to aspirate the cystic lesion, obtaining thereabout 80 ml of clear liquid, and capsule and scolex exeresis. In the follow-up, after on eyear, there has been regression on the image exams, showing residual encephalomalacia area, remission of the seizures and the cognitive deficit, and the anticonvulsants were suspended after three years without attacks.

DISCUSSION: Neurocysticercosis is an important cause of epilepsy in developing countries, with behavior changes beyond the increased intracranial pressure. Even as the presented case, cerebral lesions are commonly found in brain imaging exams, due to the installation of the parasite in brain tissue and the immune reaction produced. The treatment, occasionally, is a challenge for the professional, needing clinical approach with antiparasitic and anticonvulsants, besides the surgical approach. In the case in question, all the forms of treatment were made, aiming at the remission of the parasite and the symptoms.

FINAL COMMENTS: This case evidences a rare form of neurocysticercosis of giant brain cyst, with the differential diagnosis of neoplastic lesions. The treatment of this patient was effective, with efficient results. Thereby, it is necessary to pay attention to the symptoms and the disease incidence in our region, aiming at the improvement of the patient’s clinical condition.

Palavras Chave

neurocysticercosis