[Presentation of cerebral toxocariasis with mental confusion in an adult: case report and review of the literature]. / Toxocarose cérébrale révélée par une confusion mentale chez un adulte à Nantes: cas clinique et revue de la littérature.

Toxocariasis is usually responsible for visceral larva migrans syndroms. Nervous system involvement is a rare complication. In this report, we describe one case of meningoencephalitis due to Toxocara canis in a 73-year-old man presenting with mental confusion. The diagnosis of cerebral toxocariasis was confirmed by immunodiagnosis in both serum and cerebro-spinal fluid. Cerebral toxocariasis may be suspected in patients presenting with some neurological patterns including: confusion, meningitis, meningo-encephalitis, meningo-myelitis, when the etiological assessment remains negative and the environmental context is favourable. Finding evidence of specific antibodies in both cerebro spinal fluid and serum is mandatory for the diagnosis. The main clinical features concerning cerebral toxocariasis, diagnostic tools, and therapeutic measures are discussed.

Seizure disorder mimicking an acute confusional state as clinical presentation of neurocysticercosis: neuroimaging, EEG findings and clinical correlations.

Epilepsy is the main clinical manifestation of neurocysticercosis (NC). We studied an adult subject who presented a seizure disorder mimicking an acute confusional state as clinical expression of NC. Diagnosis was made with neuroimaging and western blot determination of specific antibodies on serum. Computed tomography and magnetic resonance imaging displayed multiple calcifications and a few transitional cysts in the cerebral parenchyma. Electroencephalography showed a pattern of periodic lateralized epileptiform discharges (PLEDs) which could be related topographically to a cystic lesion located in the left parietal lobe. In our view there was a clear pathogenic correlation between the seizure disorder and the parasitic cyst located in the left parietal lobe. Neither antiepileptic drugs nor steroids were prescribed. Follow-up to one year ruled out other clinical manifestations of the disease. This case is an example of acute symptomatic seizure related to a transitional cystic lesion of NC.