Neurocysticercosis — SCE Infectious Diseases MCQ

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ModerateTropical & Imported InfectionsNeurocysticercosisSCE Infectious Diseases

A 45-year-old man from rural Mexico presents with new-onset seizures. MRI brain shows multiple small ring-enhancing cystic lesions with a scolex (bright dot) visible within several cysts. He has peripheral eosinophilia. What is the most likely diagnosis?

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Correct answer: A — Neurocysticercosis (Taenia solium)

Multiple cystic ring-enhancing lesions with a visible scolex (the 'hole-with-dot' sign) on MRI, plus eosinophilia and exposure to endemic areas for Taenia solium (Mexico, Central/South America, sub-Saharan Africa, South-East Asia) is diagnostic of neurocysticercosis. Treatment depends on the stage of infection: viable cysts may be treated with Albendazole 400 mg BD for 10–14 days plus Praziquantel, with concomitant Dexamethasone to reduce peri-cystic inflammation and anti-epileptic drugs for seizure control.

Reference: WHO 2022 – Taeniasis/cysticercosis guidelines; BIA 2019 – Neurocysticercosis