Optic Nerve Cysticercosis: Case Report and Review of Current Management

Abstract

The authors present a case of optic nerve cysticercosis in a 32-year-old patient who presented with sudden blurring of vision in the left eye and a transient visual improvement on systemic steroids. The ocular findings were unremarkable other than a relative afferent pupillary defect (RAPD). An ultrasound of the orbit, CT and MRI scans revealed a cystic lesion in the orbital portion of the optic nerve close to the eyeball. A presumed diagnosis of optic nerve cysticercosis was made on the basis of imaging and a positive serum ELISA. The patient improved dramatically on a 4-week therapeutic trial of albendazole and oral steroids. The post-treatment ultrasound and CT scan showed an involution of the cyst with some residual thickening of the optic nerve.

Neurocysticercosis presenting as Millard Gubler syndrome

“…Neuroretinitis and occipital lobe syndrome have been reported in four patients of neurocysticercosis. [6] We here report a case of neurocysticercosis presenting as left VI and VII th cranial nerve palsy of lower motor neuron type and contralateral hemiplegia, i.e., Millard Gubler syndrome, which is unreported in literature.…”

Entrapment ulnar neuropathy caused by cysticercosis

“…Once this is relieved, functional recovery is complete. Apart from peripheral neuropathy, cranial nerve neuropathies caused by cysticercosis involving the second, third, fourth and fifth cranial nerves have been described in literature [12][13][14].…”

Minimally Invasive Bone-Saving Orbitotomy for Removal of Optic Nerve Cysticercosis

“…It has been described to present with a picture of neuroretinitis and has been previously managed with both conservative and surgical therapy. [1][2][3][4][5][6][7] The cases described in the literature have had isolated optic nerve involvement. The present case report describes a known case of neurocysticercosis with a secondary optic nerve involvement.…”

“…[1][2][3][4][5][6][7] Although previous reports describe treatment with albendazole and steroids, 1,2 visual recovery in such cases has typically been limited. Surgical excision has been previously been described with total removal being achieved through a lateral orbitotomy.…”