Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 13 , ISSUE 2 ( March-April, 2021 ) > List of Articles

Original Article

Diagnostic Dilemma: Neurocysticercosis—A Differential Diagnosis for Seizures in Pregnancy and Early Postpartum Period

Shilpi Singh, M Munikrishna

Keywords : MRI brain, Neurocysticercosis (NCC), Postpartum convulsion

Citation Information : Singh S, Munikrishna M. Diagnostic Dilemma: Neurocysticercosis—A Differential Diagnosis for Seizures in Pregnancy and Early Postpartum Period. J South Asian Feder Obs Gynae 2021; 13 (2):84-86.

DOI: 10.5005/jp-journals-10006-1873

License: CC BY-NC 4.0

Published Online: 09-07-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

The most common helminthic infestation of the brain worldwide is neurocysticercosis (NCC). When a woman presents with seizures during pregnancy, eclampsia is the go to provisional diagnosis. NCC may be misdiagnosed because of its symptoms like headache, vomiting and nausea, neurological and visual disturbances, and seizures. Hence, radiological findings help to diagnose NCC. Treatment is with antiepileptics and antihelminthic agents. We reported the cases of three Indian women in our tertiary care center, aged 19, 20, and 22 years, respectively, with NCC, one of whom presented with seizures in the first trimester of pregnancy and other two during the postpartum period. All patients were normotensive with urine albumin nil and no history of increased blood pressure in the past. The confirmation was done on the basis of MRI brain, which showed spherical ring-enhancing lesions that were calcified in the brain. In the first patient aged 19 years, pregnancy was terminated on patient request and she was discharged on albendazole and levetiracetam. The second and the third patients whose antenatal period was uneventful with postpartum convulsions were also put on levetiracetam and albendazole for 21 days.


PDF Share
  1. Patel RD, Mishra I, Pandya NC. An unusual case of intercurrent eclampsia. J South Asian Feder Obst Gynae 2014;6(1):39–40. DOI: 10.5005/jp-journals-10006-1266.
  2. Del Brutto OH. Neurocysticercosis a review. Sci World J 2012:1–8. DOI: 10.1100/2012/159821.
  3. Jamadarkhana S, Law RC. Seizures in the early post-partum period: a diagnostic dilemma. Indian J Anaesth 2012;56(2):183–185. DOI: 10.4103/0019-5049.96339.
  4. Kokila M, Dwivedi AD. Correlation of clinical and neuroimaging findings affecting management in postpartum eclampsia: a prospective study. J South Asian Feder Obs Gynae 2011;3(3): 125–130. DOI: 10.5005/jp-journals-10006-1147.
  5. Kaur A, Kaur B, Kaur MM, Manoj M. Neurocysticercosis misdiagnosed in pregnancy as eclampsia: outcome and management. Ann Woman Child Health 2016;2(3):32–36.
  6. Garcia H, Nash T, Del Brutto O. Clinical symptoms, diagnosis, and treatment of neurocysticercosis. Lancet Neurol 2014;13(12):1202–1215. DOI: 10.1016/S1474-4422(14)70094-8.
  7. Escobar A. The pathology of cysticercosis. In: Palacios E, editor. Cysticercosis of the central nervous system. Springfield, IL: Charles C. Thomas 1983: pp. 27–54.
  8. Nash T, Pretell EJ, Lescano AG, Bustos JA, Gilman RH, Gonzalez AE, et al. Perilesional brain oedema and seizure activity in patients with calcified neurocysticercosis: a prospective cohort and nested case-control study. Lancet Neurol 2008;7(12):1099–1105. DOI: 10.1016/S1474-4422(08)70243-6.
  9. Nash T. Edema surrounding calcified intracranial cysticerci: clinical manifestations, natural history and treatment. Pathogens Global Health 2012;106(5):275–279. DOI: 10.1179/2047773212Y.0000000026.
  10. D Cruz RF, Ng SM, Dassan P. Case report. Neurocysticercosis in pregnancy: maternal and fetal outcomes. OMCR 2016;2016(7):138–140. DOI: 10.1093/omcr/omw019.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.