LARGE CEREBRAL INFARCTION DURING PRAZIQUANTEL THERAPY IN NEUROCYSTICERCOSIS

Background Large cerebral infarction is a rare complication of neurocy sticercosis. Endarteritis by inflammation of the leptomeninges is know n to be its cause. Case Description A 59-year-old man with known neuro cysticercosis developed a large cerebral infarction during praziquante l therapy. A follow-up MRI obtained immediately after his cerebral inf arction demonstrated notable decrease in the size of the cysts and mor e prominent enhancement around the peripheral margins of the cysts and the major vessels in comparison with the initial MRI. Cerebral angiog raphy disclosed occlusions and narrowing of both internal carotid arte ries at the supraclinoid portions, where multiple cysts were found on the MRI. Conclusions Findings in our patient strongly suggest that a s econdary inflammation reaction caused by the destruction of the cysts might have enhanced the process of endarteritis. The possible deleteri ous effects of praziquantel therapy should be considered in the treatm ent of patients with subarachnoid cysticerci.