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NewYork-Presbyterian Hospital Psychiatry
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Case of the Month - April 2017

This 38 year old male presented to the ED after his first ever seizure.

Question 1 : What’s wrong with this picture?

radiology-image-1



View answer
Answer 1:

There are scattered calcifications throughout the brain which can be seen in prior infection/inflammation such as neurocysticercosis (arrows below). This patient was originally from Guatemala.



radiology-image-1




Question 2: What type of testing and treatment would you expect him to get next?
View answer
Answer 2:

The workup of suspected neurocysticercosis includes CT and possibly MRI of brain (MRI detects certain cysts better than CT scan), possible serologic testing and ophthalmologic exam to assess for ocular involvement (which can be vision-threatening.)

This patient had imaging compatible with neurocysticercosis, a normal ophtho exam and elevated cysticercosis Ab (IgG). He was discharged on hospital day 3 on albendazole and prednisone.



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