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Neurocysticercosis — SCE Neurology MCQ

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HardCNS InfectionsNeurocysticercosisSCE Neurology

A 34-year-old develops focal seizures after living in an endemic region. MRI shows multiple parenchymal cysts at different stages, including a lesion with an eccentric scolex. There is no hydrocephalus, but fundoscopy has not yet been performed. What is the most appropriate next management principle?

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Correct answer: A — Treat seizures before cysticidal therapy, including ocular and intracranial-pressure assessment

Management of parenchymal neurocysticercosis is individualised. Seizures require treatment, and specialist assessment should address ocular disease and raised intracranial pressure before cysticidal therapy, because treatment-related inflammation can worsen neurological or ocular injury.

Reference: UK Government evidence summary on neurocysticercosis: https://www.gov.uk/research-for-development-outputs/anthelmintics-for-people-with-neurocysticercosis