Spinal Cord Compression and Bilateral Sensory Neural Hearing Loss: An Unusual Manifestation of Neurocysticercosis
Wasin Jarupant MD*, Pasiri Sithinamsuwan MD*, Chesda Udommongkol MD*, Kritti Reuarrom MD**, Samart Nidhinandana MD*, Jithanorm Suwantamee MD*
Affiliation : * Department of Medicine, Pramongkutklao Army Hospital ** Department of Medicine, Bhumibol Adulyadej Airforce Hospital
Neurocysticercosis is the most common parasitic infestation involving the central nervous system in tropical countries. Common presentations are seizure, meningitis and increased intracranial pressure. The authors report a case of a 52-year-old woman with racemose neurocysticercosis in the subarachnoid space at the cistern of the brain through the lumbar cistern. She presented with progressive paraparesis due to spinal cord compression and finally had progressive bilateral sensori-neural hearing loss. MRI brain and the whole spinal cord revealed numerous rim-enhancing cystic lesions at the basal cistern, prepontine cistern, bilateral cerebellopontine angle, internal acoustic canals, intramedullary lesion at the 5th cervical spinal level, lumbar cistern lesions and secondary syringomyelia at the thoracic spinal cord. The histopathologic examination confirmed cysticercosis. After treatment by albendazole and surgical removal, she still developed recurrent spinal compression at a higher level and obstructive hydrocephalus. Finally, she died from status epilepticus and septic shock.
Keywords : Neurocysticercosis, Racemose, Spinal cord compression, Sensori-neural hearing loss, Cerebellopontine angle
