Orbital cysticercosis masquerading as trochleodynia

Trochleodynia is described as a headache caused by peritrochlear inflammation. It presents with tenderness in the trochlear area with exacerbation of vertical eye movements. It is principally idiopathic, but sometimes it is seen in association with other causes like sinusitis or rarely with immune mediated diseases.Cysticercosis is a tissue infection caused by the larval form of the parasite, Taenia solium. The parasite can infect the brain, muscle, eye and other tissues. The presenting features vary according to the site of lodgement of the larva. The extraocular muscles of the eye are the most common site of orbital form of cysticercosis.We report a case in which the lodgement of the cysticercus in the orbit, adjacent to the trochlea caused clinical features suggestive of trochleodynia. Neuroimaging was instrumental in arriving at the true diagnosis of cysticercosis.