Rapidly Progressive Dementia in a Patient with Racemose Neurocysticercosis

Abstract

Racemose Neurocysticercosis (NCC) is a rare entity characterized by the presence of progressively enlarging cystic lesions as the scolex degenerates. The location of these lesions dictates the clinical manifestations. This case report describes a 65 year old female patient who developed rapidly progressive dementia over four months, associated with gait disturbance and impaired bladder control. Her initial CT scan confirmed an increase in the volume of the lateral ventricles and a cystic lesion in the ambient cistern, along with multiple calcifications. During her initial evaluation, she showed improvement after lumbar puncture and ventriculoperitoneal (VP) shunt placement, becoming able to walk unassisted. However, due to a lack of follow-up, she experienced VP shunt failure and further deterioration, which was confirmed by neuroimaging, revealing an even rarer case of racemose NCC within the lateral ventricles. The objective of this case report is to highlight diagnostic suspicion, differential diagnosis, the importance of control and follow-up, and the treatment of a rare pathology.