Report of three patients with extensive neurocysticercosis in rural southern Tanzania: neurological, serological and neuroradiological findings

Stelzle D, Makasi C, Welte TM, Ruether C, Schmidt V, Gabriel S, Bottieau E, Fleury A, Ngowi BJ, Winkler AS, Trevisan C, Van Damme I, Magnussen P, Zulu G, Chabala C, Mubanga C (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Journal of Medical Case Reports BMC

Book Volume: 17

Article Number: 311

Journal Issue: 1

DOI: 10.1186/s13256-023-03974-2

Abstract

Background: Neurocysticercosis (NCC) is common in eastern Africa, but disease presentation varies considerably. Most patients have single or few NCC-typical lesions in their brain but some present with a large number of lesions. We present three patients with positive antibody-based serology for Taenia solium cysticercosis screened at the Vwawa district hospital, Mbozi district, southern Tanzania, in whom extensive NCC was confirmed by neuroimaging. Case presentations: Patient 1 was a 55-year-old female from the tribe Malila smallholder farmer who has had four generalized tonic–clonic epileptic seizures over a period of 11 years and one episode of transient left hemiparesis one year before seizure onset. The patient also reported monthly to weekly episodes of severe, progressive, unilateral headache. The computed tomography (CT) scan of the brain showed 25 NCC lesions of which 15 were in the vesicular stage. Patient 2 was a 30-year-old male from tribe Nyha mechanic who reported monthly episodes of moderate to severe, progressive, bilateral headache, but no epileptic seizures. The CT scan showed 63 NCC lesions of which 50 were in the vesicular stage. Patient 3 was a 54-year-old female from the tribe Malila smallholder farmer who suffered from frequent generalized tonic–clonic epileptic seizures with potential signs of focal seizure onset. She also reported weekly to daily episodes of severe, progressive, unilateral headache. The CT scan showed 29 NCC lesions of which 28 were in the vesicular stage. Conclusions: Clinical presentation of NCC with multiple brain lesions varies considerably ranging from few epileptic seizures and severe headache to severe epilepsy with frequent epileptic seizures. Individuals with neurological signs/symptoms that may be due to NCC, based for example on epidemiological criteria or serological evidence of cysticercosis, are recommended to undergo neuroimaging before anthelminthic treatment is considered.

Involved external institutions

RoMed Kliniken - Kliniken der Stadt und des Landkreises Rosenheim GmbH DE Germany (DE) Technische Universität München (TUM) DE Germany (DE) National Institute for Medical Research, Tanzania (NIMR) TZ Tanzania, United Republic of (TZ) Universiteit Gent (UGent) / Ghent University BE Belgium (BE) Institute of Tropical Medicine Antwerp / Prins Leopold Instituut voor Tropische Geneeskunde (ITG) BE Belgium (BE) National Autonomous University of Mexico / Universidad Nacional Autónoma de México (UNAM) MX Mexico (MX)

How to cite

APA:

Stelzle, D., Makasi, C., Welte, T.M., Ruether, C., Schmidt, V., Gabriel, S.,... Mubanga, C. (2023). Report of three patients with extensive neurocysticercosis in rural southern Tanzania: neurological, serological and neuroradiological findings. Journal of Medical Case Reports, 17(1). https://dx.doi.org/10.1186/s13256-023-03974-2

MLA:

Stelzle, D., et al. "Report of three patients with extensive neurocysticercosis in rural southern Tanzania: neurological, serological and neuroradiological findings." Journal of Medical Case Reports 17.1 (2023).

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