Migraine-Like Visual Hallucinations in Occipital Lesions of Cysticercosis

Sharma, Kumudini; Wahi, Jessica E.; Phadke, Rajendra V.; Varma, Adithya; Jain, Vivek

doi:10.1097/00041327-200206000-00003

Cited by 12 publications

(5 citation statements)

References 8 publications

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“…Several population- [3,4] and clinic-based [8-10] studies have shown that primary headaches are more prevalent in subjects with neurocysticercosis. Neurocysticercosis with occipital lesions can even mimick migraine with visual aura [11-13], which was not the case in our patient.…”

Section: Discussionmentioning

confidence: 66%

Cerebral neurocysticercosis mimicking or comorbid with episodic migraine?

et al. 2014

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BackgroundNeurocysticercosis is a major cause of neurological symptoms in developing countries. We report a case of cerebral neurocysticercosis presenting as episodic migraine without aura, with clinico-radiological correlations and discuss the possible causal influence of neurocysticercosis on the pathomechanisms of migraine.Case presentationWe report a 24 year-old male consulting for a one year history of recurrent headaches. He described bilateral frontal and/or temporal attacks of throbbing headache, moderate to severe in intensity, worsened by head movements and accompanied by nausea, photophobia and phonophobia. Attacks lasted between 12 and 60 hours if untreated. He never had symptoms suggestive of a migraine aura or an epileptic seizure. Headache attacks progressively increased in frequency to up to 5 to 7 severe attacks per month. On taking history, the patient reported having consumed undercooked porcine meat. Physical examination was unremarkable. A brain CT scan showed two contiguous occipital cystic lesions with ring enhancement and surrounding edema suggestive of cerebral neurocysticercosis. On laboratory work-up, blood serology for cysticercal antibodies was positive. Full blood count, erythrocyte sedimentation rate, c - reactive protein level, human immunodeficiency virus serology, liver and hepatic function were all normal. Albendazole (1000 mg/day) and prednisolone (60 mg/day) were prescribed for seven days. The patient was examined again two and six months after the end of his treatment and there was a significant reduction in headache severity and frequency.ConclusionWe propose that in our patient the occipital neurocysticercosis lesions cause migraine without aura-like attacks via inflammation in the surrounding brain parenchyma leading to sensitization of the trigemino-vascular system. We cannot rule out, however, the possibility that our patient has a genetic predisposition for migraine without aura and that the fortuitous association of neurocysticercosis is simply an aggravating factor of his migraine.

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Section: Discussionmentioning

confidence: 66%

Cerebral neurocysticercosis mimicking or comorbid with episodic migraine?

et al. 2014

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“…Both patients became seizure-free with appropriate treatment of the underlying disease and epileptic seizures. Sharma et al 21 reported four other patients with single cysticercus granuloma in the occipital lobe who presented with migraine-like visual hallucinations.…”

Section: Discussionmentioning

confidence: 99%

Transient cortical blindness as a manifestation of solitary cysticercus granuloma

Hussain

2012

BMJ Case Reports

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Neurocysticercosis is recognised as a significant cause of neurological morbidity in endemic regions. The wide range of pleomorphic and non-specific neurological manifestations of neurocysticercosis must be kept in mind by physicians, as the disease has shown resurgence in developed countries. When an atypical presentation of an unusual tropical disease occurs in non-endemic regions, the diagnosis is often missed. We describe a case of a 4-year-old girl who presented with a history of transient bilateral loss of vision with headache and vomiting. Brain MRI revealed the presence of a single cysticercus granuloma in the occipital lobe. A diagnosis of symptomatic occipital lobe seizure secondary to neurocysticercosis was made. She was given a course of albendazole. There was no recurrence of symptoms at 3 years follow-up. Occipital seizures that are associated with ictal amaurosis closely mimic basilar migraine. Such cases benefit from neuroimaging in order to rule out the underlying structural causes.

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“…Epileptic seizures can be present at any stage. However, seizures are manifested mainly in stage III, as the death of the cysticercus releases larval antigens that stimulate an inflammatory host response (4) . Generally in stages I and II seizures are not induced (2) .…”

Section: Case Reportmentioning

confidence: 99%

“…Our case has led us to be more careful about such lesions and helminthic infections, which should be considered in the differential diagnosis that may include glioneuronal tumors such as ganglioglioma or dysembryoplastic neuroepithelial tumors, and small abscess due to tuberculosis, which is relatively common in Turkey since there is no specific MRI appearance that could be suggestive of neurocysticercosis. We have to underline that if we were able to make the correct diagnosis depending on the preoperative images, we would not take the patient to the operating room given that the primary mode of the treatment is medical rather than surgery (4) .…”

Section: Case Reportmentioning

confidence: 99%

Neurocysticercosis: A Rare Cause of Occipital Lobe Epilepsy

Küçükyürük

Tanrıverdi

Öz³

et al. 2014

sscd

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Thirteen-year-old boy admitted to our clinic because of intractable occipital lobe epilepsy and underwent surgical resection of epileptogenic focus at the left occipital lobe. Histopathological examinations revealed a parasitic infestation, neurocystocercosis. After surgery the patient was seizurefree at short-term follow-up and referred to the outpatient clinic of Infectious Diseases for futher medical treatment of taenia solium. A case of intractable occipital lobe epilepsy due to cysticersosus was discussed with possible pitfalls in diagnosis.

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Migraine-Like Visual Hallucinations in Occipital Lesions of Cysticercosis

Cited by 12 publications

References 8 publications

Cerebral neurocysticercosis mimicking or comorbid with episodic migraine?

Cerebral neurocysticercosis mimicking or comorbid with episodic migraine?

Transient cortical blindness as a manifestation of solitary cysticercus granuloma

Neurocysticercosis: A Rare Cause of Occipital Lobe Epilepsy

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