Large cerebral infarction during praziquantel therapy in neurocysticercosis.
BACKGROUND
Large cerebral infarction is a rare complication of neurocysticercosis. Endarteritis by inflammation of the leptomeninges is known to be its cause.


METHODS
A 59-year-old man with known neurocysticercosis developed a large cerebral infarction during praziquantel therapy. A follow-up MRI obtained immediately after his cerebral infarction demonstrated notable decrease in the size of the cysts and more prominent enhancement around the peripheral margins of the cysts and the major vessels in comparison with the initial MRI. Cerebral angiography disclosed occlusions and narrowing of both internal carotid arteries at the supraclinoid portions, where multiple cysts were found on the MRI.


CONCLUSIONS
Findings in our patient strongly suggest that a secondary inflammation reaction caused by the destruction of the cysts might have enhanced the process of endarteritis. The possible deleterious effects of praziquantel therapy should be considered in the treatment of patients with subarachnoid cysticerci.
Bang
O Y
OY
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Heo
J H
JH
Choi
S A
SA
Kim
D I
DI
D000980:Antiplatyhelmintic Agents / Q000009:adverse effects*; D001479:Basal Ganglia / Q000000981:diagnostic imaging; D001927:Brain Diseases / Q000188:drug therapy / Q000469:parasitology* / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology*; D003551:Cysticercosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007249:Inflammation; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology; D008875:Middle Aged; D010296:Parietal Lobe / Q000000981:diagnostic imaging; D011223:Praziquantel / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
D000980:Antiplatyhelmintic Agents; D011223:Praziquantel