Unusual Painful Trigeminal Neuropathy Caused by Racemose Neurocysticercosis

Filho, Pedro Tadao Hamamoto; Poliseli, Gianfelipe Belini; Oliveira, Victor Azevedo de; Vital, Roberto; Lima, Márcia Maria Ferreira; Bazan, Rodrigo; Zanini, Marco Antônio

doi:10.1093/pm/pnv081

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…Their other case of NCC of the CPA with ipsilateral neuralgia was also alleviated after excision of the cysts. Hamamoto Filho et al 26 reported another case secondary to ipsilateral NCC cysts in the CPA, in the absence of vascular compression. Aguiar et al 27 reported another singular case—that is, a patient with bilateral TN with images of cystic lesions in the right CPA, which was finally reported as NCC, who also presented with neuralgia on the left side.…”

Section: Discussionmentioning

confidence: 99%

Trigeminal neuralgia secondary to vascular compression and neurocysticercosis: illustrative case

Vásquez¹,

Saavedra²,

Garcı́a³

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Trigeminal neuralgia (TN) is a frequent neurosurgical problem negatively influencing the quality of life of patients. The standard surgical treatment is microvascular decompression for primary cases and decompression of the mass effect, mainly tumors, for secondary cases. Neurocysticercosis (NCC) in the cerebellopontine angle is a rare etiology of TN. The authors report a case in which NCC cysts around the trigeminal nerve coexisted with a vascular loop, which compressed the exit of the trigeminal nerve from the pons. OBSERVATIONS A 78-year-old woman presented with a 3-year history of persistent severe pain in the left side of her face, refractory to medical treatment. On gadolinium-enhanced magnetic resonance imaging, cystic lesions were observed around the left trigeminal nerve and a vascular loop was also present and in contact with the nerve. A retrosigmoid approach for cyst excision plus microvascular decompression of the trigeminal nerve was successfully performed. There were no complications. The patient was discharged without facial pain. LESSONS Albeit rare, TN secondary to NCC cysts should be considered in the differential diagnosis in NCC-endemic regions. In this case, the cause of the neuralgia was probably both problems, because when both were treated, the patient improved.

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Section: Discussionmentioning

confidence: 99%

Trigeminal neuralgia secondary to vascular compression and neurocysticercosis: illustrative case

Vásquez¹,

Saavedra²,

Garcı́a³

et al. 2023

Journal of Neurosurgery: Case Lessons

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“…The inflammatory reactions that may be triggered upon anthelminthic treatment can either initiate or deteriorate the previous compressive effect. For cranial nerves, there have been reported cases of visual loss, trigeminal pain, and facial nerve dysfunctions secondary to the compressive effects of cisternal cysts [ 55 , 56 , 57 , 58 ]. Cysts in the subarachnoid space of the spine can compress the spinal roots and the spinal cord.…”

Section: Surgical Removal Of Cystsmentioning

confidence: 99%

Current Role of Surgery in the Treatment of Neurocysticercosis

Hamamoto Filho,

Norcia,

Fleury

et al. 2024

Pathogens

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Neurocysticercosis (NCC) is a common parasitic disease of the central nervous system (CNS) in low- and middle-income countries. The infection is pleomorphic, caused by the larval form of the cestode, Taenia solium, and part of the heterogeneity of its clinical presentations is associated with the localization of the parasite within the CNS. Changes in the current epidemiological trends of NCC indicate that extra-parenchymal NCC is proportionally becoming more frequent. Extraparenchymal NCC is commonly accompanied by raised intracranial hypertension due to hydrocephalus, which is an emergency requiring cyst extirpation by surgical intervention to relieve the symptoms. Although less frequent, parenchymal cysts may also reach giant sizes requiring urgent surgical treatment. Finally, there is an advancement in the comprehension of the association between NCC and epilepsy—and patients with drug-resistant seizures are candidates for surgical treatment. In this narrative review, we summarize the present state of knowledge to update the current trends in the role of surgery in the treatment of NCC.

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“…Other sensational clinical and radiological manifestations of racemose, described in the literature is the trigeminal neuralgia due to multiple cysts in the posterior fossa cisterns, mainly in the cerebellopontine angles. 18 Grape-like clusters in the sellar and suprasellar regions is also reported to cause characteristic syndrome with amenorrhoea, recurrent vomiting, headache and increased fatigue. 19 Chronic papilledema with bilateral optic atrophy was also reported by Matalia et al 20 and attributed to multiloculated cysts in the basal cisterns, right sylvian, and anterior interhemispheric fissure with moderate obstructive hydrocephalus.…”

Section: Epidemiologymentioning

confidence: 99%

Neuroimaging Findings in Racemose Neurocysticercosis: Case Description and Literature Review

Kollia

Theodorou

Zervas

et al. 2021

J Neurosonol Neuroimag

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Neurocysticercosis (NCC), the most common central nervous system (CNS) parasitic infection among the immunocompetent population can imitate every clinical feature of brain-diseases accurately, drawing attention away from the real culprit and delaying the proper treatment. There are two types of NCC, the parenchymal and the extraparenchymal form. The extraparenchymal NCC include the ventricular cysticercosis, the subarachnoid cysts including giant cysts or racemose cysticercosis with chronic meningitis, the spinal (intra- or extramedullary) cysticercosis and the ophthalmic cysticercosis. It is estimated that about 30% of epilepsy cases in endemic countries are due to NCC and especially the racemose NCC is more aggressive and associated with higher mortality rates. There is a significant heterogeneity in clinical phenotypes, regarding the racemose NCC, which depends on the parasite load and evolutionary stage in association with its location in CNS and the host’s immune response. Crucial for the management of the racemose NCC is the early recognition of the symptoms and the swift initiation of antiparasitic therapy with anti-inflammatory agents in combination with the shunt-insertion in cases of obstructive hydrocephalus. In view of the former considerations we conducted a narrative literature review on racemose NCC and described the diagnostic challenges of a relevant case that we had evaluated in our Department of Neurology.

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Unusual Painful Trigeminal Neuropathy Caused by Racemose Neurocysticercosis

Cited by 5 publications

References 10 publications

Trigeminal neuralgia secondary to vascular compression and neurocysticercosis: illustrative case

Trigeminal neuralgia secondary to vascular compression and neurocysticercosis: illustrative case

Current Role of Surgery in the Treatment of Neurocysticercosis

Neuroimaging Findings in Racemose Neurocysticercosis: Case Description and Literature Review

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