Isolated intramedullary spinal cysticercosis: A case report with review of literature of a rare presentation

Abstract

A number of parasitic infections can involve the central nervous system of which neurocysticercosis (NCC) is the most common one in developing countries. Most often the brain is involved, spine and spinal cord involvement is very rare and intramedullary involvement is rarer still. Here, we report a 30-year-old male patient, with intramedullary NCC of dorsal spinal cord.

Intramedullary Cysticercosis- An Uncommon Entity Even in the Presence of Intracranial Neurocysticercosis

“…The most common parasitic central nervous system involvement, neurocysticercosis (NCC) is caused by the larval form of a nematode, Taenia solium. [1,2] NCC is endemic in various low socio-economic countries like Africa, Mexico, Latin America and Asia, including India. [4,5] NCC is considered to be the most common cause of acquired epilepsy as 80% of cases present with seizures.…”

“…Even though intracranial neurocysticercosis is a well known parasitic infestation of CNS worldwide, intraspinal involvement, and particularly intramedullary NCC, is extremely rare even in endemic areas despite being known to coexist with intracranial NCC. [1,4] George A Alsina et al (2002) in their study brought out less than 200 reported cases of spinal NCC worldwide even after including three fourth cases having an underlying/associated intracranial NCC. [9] It is postulated that approximately 100 fold blood supply of brain parenchyma as compared to spine is responsible for an increased incidence of intracranial NCC and intramedullary lesion results from direct hematogenous or ventriculo-ependymal spread.…”

“…Neurocysticercosis (NCC) is described as the central nervous system involvement by a parasitic infection caused by a nematode, Taenia solium. [1,2] Predominantly being intracranial disease, the spinal NCC is anatomically classified as extraspinal and intraspinal. Extraspinal NCC constitutes vertebral NCC, whereas, intraspinal NCC comprises of epidural, subdural intramedullary and arachnoid NCC.…”

“…Extraspinal NCC constitutes vertebral NCC, whereas, intraspinal NCC comprises of epidural, subdural intramedullary and arachnoid NCC. [1,3] Intraspinal involvement by NCC is very rare with an incidence of 1.5-3.0% with intramedullary being even rarer. [1] Intramedullary lesions have significant morbidity due to limited size of spinal canal.…”

“…[1,3] Intraspinal involvement by NCC is very rare with an incidence of 1.5-3.0% with intramedullary being even rarer. [1] Intramedullary lesions have significant morbidity due to limited size of spinal canal. Despite being located at a critical area of spine, these lesions are fairly treatable by resection.…”