Neurocysticercosis with spinal cord involvement, case report

Abstract

Introduction: Cysticercosis is caused by the larval stage Taenia solium. Clinical manifestations are divided into neurocysticercosis (intra- or extraparenchymal) and extraneural cysticercosis. Despite being an endemic disease in Brazil, in only 1% of cases it occurs with spinal cord injury. The aim is to report a case of subarachnoid neurocysticercosis with spinal cord involvement in a patient at Hospital Geral de Goiânia. Information was obtained through clinical follow-up in a neurology ward. Case report: Female, 59 years old, patient with initial stabbing back pain at rest, evolving with lower limb paresthesia and progressing to paraparesis and paraplegia with urinary and fecal retention. On examination, areflexia in the lower limbs, Babinski and alteration of proprioception and palesthesia. On thoracic spine magnetic resonance imaging, the presence of a signal suggesting a subarachnoid blood component in metabolization and loculation of an anterolateral cystic configuration on the right at T4-T5 level, compressing and displacing the thoracic spinal cord, in addition to an alteration in the distribution of the roots of the cauda equina adjacent to the medullary cone with post-contrast intradural radicular enhancement in the equine tail, suspicious findings for arachnoiditis. The patient was urgently referred for neurosurgery, which, during the procedure, showed the presence of cysticercus and also the anatomopathological examination. Conclusion: Despite being an endemic disease in Brazil, extraparenchymal neurocysticercosis with spinal cord involvement is rare, and it is necessary to report it in order to include it in the differential diagnoses of spinal cord diseases.