The Value of MRI in the Diagnosis and Management of Neurocysticercosis

SH Ng, TY Tan, KM Fock
Correspondence: Dr S H Ng

ABSTRACT
The clinical manifestation of neurocysticercosis is quite protean and variable making it the 'great imitator' of almost any neurological disorder. In the last decade, developments in diagnostic imaging and effective anticysticercus drug therapy have changed the outlook of the disease. Two cases investigated with CT scan and MRI are reported here. One case was treated effectively with antihelminthic therapy. In both cases MRI was found to be much more sensitive than CT scan in picking up the multiple cystic lesions. In addition, 'protoscoleces' and 'differential ring enhancements' not apparent in CT scan were well shown in MRI hence enabling the demonstration of different activity stages. In the treated patient, repeat MRI showed degeneration of the cyst. These illustrate that MRI is superior to CT scan in both the diagnosis and management of the illness.

Keywords: neurocysticercosis, epilepsy, MRI, CT scan, antihelminthic therapy
Singapore Med J 2000; 41(3): 132-134