Chronic Myelopathy Associated to Intramedullary Cysticercosis

Abstract

Case report. Discuss an isolated intramedullary neurocysticercosis (NCC) case in an adult patient with chronic progressive onset myelopathic symptomatology with clinical, radiologic, and pathologic correlation. NCC is the most common parasitic infection in the central nervous system. Spinal NCC belongs to the group of extraparenchymal forms of NCC and it is considered an extremely rare form characterized by a distinct clinical entity due to mass effect on the spinal cord. Description of a 62-year-old male patient case who presented with chronic but progressive low cord myelopathy who underwent radiologic investigation through magnetic resonance imaging depicting a thoracic intramedullary cystic lesion at level T11. Surgical excision of the intramedullary lesion was preformed and pathologic study confirmed a cysticercus. There was complete resolution of the neurologic symptoms and follow-up monitoring was unremarkable. Although intramedullary is a rare NCC location, it should be considered in the differential diagnosis in high-risk populations especially when cord compression and myelopathy symptoms are present. Magnetic resonance imaging remains the investigative and follow-up modality of choice, and promptly lesion recognition is fundamental for surgical planning and to improve the patient outcome.