Neurocysticercosis Encephalitis in a Child with Disseminated Cysticercosis

Abstract Background: Cysticercosis, a common parasitic infestation in endemic regions, may rarely cause widespread dissemination throughout the body resulting in disseminated cysticercosis (DCC), scarcely reported in children. Clinical Description: An 8-year-old boy from rural India presented with a 2-week history of headache, abnormal movements, intermittent fever, vomiting, and altered sensorium. Clinical examination revealed generalized hypertonia and signs of raised intracranial pressure. Brain imaging displayed a “starry sky” pattern indicative of neurocysticercosis (NCC) encephalitis. Further imaging revealed cystic lesions throughout the thoracic, abdominal, and paraspinal muscles, confirming DCC. Management and Outcome: The patient was managed with intravenous methylprednisolone, antiepileptics, and acetazolamide, avoiding albendazole due to the risk of exacerbating cerebral edema. The patient regained consciousness after the fifth pulse of steroids and progressively improved thereafter being asymptomatic and seizure-free at the last follow-up, 3 months after discharge. Conclusion: This case creates awareness regarding a rare entity of NCC encephalitis seen in DCC. The condition may be considered in children presenting with encephalopathy in endemic regions. Supportive treatment with steroids without antiparasitic treatment may be successful.