ABSTRACT
A 40-year-old man presented with a 2-month history of headache, nausea and vomiting, with generalised seizures for the past 15â days. On examination he had bilateral papilloedema, visual acuity was 6/6 in both eyes but perimetry showed right homonymous inferior quadrantanopia. His MRI showed numerous small cystic lesions with eccentric nodules, diffusely distributed in bilateral cerebral and cerebellar hemispheres. There was also focal hydrocephalus involving occipital and temporal horns of the left lateral ventricle leading to its selective dilation. Stool examination showed ova of Taenia solium. He was treated with albendazole, prednisone and sustained release sodium valproate for 1â month. His headache resolved and he is free of seizures. Repeat perimetry at 1â month also showed resolution of visual field defect.
Subject(s)
Hydrocephalus/parasitology , Neurocysticercosis/complications , Adult , Animals , Headache Disorders/parasitology , Humans , Lateral Ventricles/parasitology , Magnetic Resonance Imaging , Male , Neurocysticercosis/drug therapy , Taenia solium , Treatment OutcomeABSTRACT
A 24-year-old woman presented with a history of high-grade fever with rigours since 3â days and bilateral sudden loss of vision since 6â h. She was conscious, oriented and her vitals were stable. She had a temperature of 101°F, anaemia, thrombocytopaenia, normal white cell count and moderate splenomegaly. On testing visual activity, she could only perceive hand movements although her pupils were bilaterally equal, and normal in size and reaction. On indirect ophthalmoscopy, optic discs were normal bilaterally; however, fovea of both eyes was masked by subhyaloid haemorrhage. Peripheral smear showed gametocytes of Plasmodium falciparum. The patient was started on arteminsinin-combined therapy and advised to be in propped-up position to help resolution of the haemorrhage. The patient was afebrile in 4â days and follow-up fundus examination showed gradual resolution of the haemorrhage. After two months, the patient regained normal visual acuity in both eyes; however, it took nearly 3â months for complete resolution of the haemorrhage.
Subject(s)
Eye Hemorrhage/etiology , Malaria, Falciparum/complications , Plasmodium falciparum , Antimalarials/therapeutic use , Artemisinins/therapeutic use , Artesunate , Eye Hemorrhage/therapy , Female , Fundus Oculi , Humans , Malaria, Falciparum/drug therapy , Mefloquine/therapeutic use , Patient Positioning , Young AdultABSTRACT
Hypoparathyroidism can present with neurological complaints like seizures, parasthesias, depression, psychosis, extrapyramidal manifestations and features of raised intracranial pressure. Hypoparathyroidism and pseudohypoparathyroidism are the most common causes of pathological basal ganglia calcification. A 50 year male presented with generalized seizures and extrapyramidal features like tremors and rigidity. Investigations revealed that he had hypocalcemia, hyperphosphatemia and very low PTH levels, CT scan of head showed calcification of bilateral basal ganglia, cerebellum and subcortical white matter of frontal and parietal lobes. He showed remarkable recovery on restoration of normal serum calcium levels. Hypoparathyroidism should be kept in the differential diagnosis of patients presenting with seizures and extrapyramidal features.