Spinal neurocysticercosis

George A. Alsina, J. Patrick Johnson, Duncan Q. McBride, Patrick R. L. Rhoten, C. Mark Mehringer, John K. Stokes
2002 Neurosurgical Focus  
8] [19] Neurocysticercosis typically involves the brain parenchyma, intracranial subarachnoid space, or ventricular system and is often self-limited unless hydrocephalus requires surgical intervention. 24 Spinal NCC is rare even in endemic regions and may require more aggressive management because of the natural confines of the spinal canal. The location of the mass lesion, its size, and the inflammatory response generated by cyst breakdown are important factors in the management of spinal NCC.
more » ... 2, 4, 15 We review six cases of spinal NCC in which the patients underwent evaluation and treatment, and we present a review of the literature. CASE REPORTS Clinical Data This report represents a retrospective review of individual patients who were treated at UCLA Medical Cen-ter and affiliated hospitals (Olive View-UCLA, Harbor-UCLA Medical Center, and Cedars-Sinai Medical Center) between 1992 and 2001 (Table 1 ). In all patients clinical evaluation for intraspinal mass lesions included MR imaging and/or CT scanning of the spinal column and brain. The diagnosis of NCC was made based on neuroimaging and serological studies in selected cases in which diagnosis remained unclear. All patients initially received dexamethasone therapy and selected patients received praziquantel therapy pre-and postoperatively. Decompressive surgery was performed in patients with progressive or persistent severe neurological deficits. Outcome was documented for as long as each patient was available for follow up, which was highly variable (range 6 months-5 years). Case 1 This 38-year-old Hispanic man with a history of intracranial NCC and hydrocephalus (previously treated by placement of a VP shunt) was evaluated for progressive lower-extremity weakness, unsteady gait, and difficulty initiating micturition over a 1-month period. Muscle strength was Grade 3-4/5 in lower extremities bilaterally with diminished reflexes. He experienced diminished sensation in his right lower extremity, and sphincter tone was Neurosurg Focus 12 (6):Article 8, 2002, Click here to return to Table of Contents
doi:10.3171/foc.2002.12.6.9 pmid:15926787 fatcat:qkif7wshnzeotjit6rwfzuhfwu