Parkinsonism Secondary to Hydrocephalus Caused by Neurocysticercosis

Abstract

The diagnosis of parkinsonism is established by the presence of tremor, stiffness and bradykinesia alongside with neurological examination, requiring the exclusion of secondary causes such as stroke, hydrocephalus and infectious diseases. Included in this last category, neurocysticercosis is a disease caused by Taenia solium, with a variable clinical presentation that can include epileptic seizures, hydrocephalus and rarely parkinsonism. In the reported case, the syndrome is a consequence of lesions in the nigrostriatal dopaminergic pathway caused by the implant and mass effect of the cysticercus. The authors report a case of parkinsonism in a 59-year-old woman with a previous history of neurocysticercosis who presented with hydrocephalus on magnetic resonance imaging exam. The patient was treated with pharmacological therapy and ventriculoperitoneal shunt, progressing with amelioration of the symptoms presented.

Neurocysticercosis and movement disorders: A literature review

“…A total of 71 articles containing 148 individuals presenting MDs related to NCC were reported [Tables 2 and 3 ]. [ 10 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 ] Between 1903 and 2020, there were 81 patients from South America, 36 from Asia, 12 from Europe, 12 from North America, and 7 from Africa. The MDs encountered were PKN, ataxia, chorea, dystonia, tremor, myokymia, myoclonus, ballism, tics, and other not clearly defined.…”

Parkinsonism and cerebrospinal fluid disorders

“…Therefore, parkinsonism is mostly reported by case reports (Table 2). Diverse parkinsonian signsincluding bradykinesia, rigidity, rest tremor, gait disturbance, and postural instabilityhave been described, and the subsequent involvement can be asymmetric or even unilateral [62][63][64][65][66][67][68].…”

“…Parkinsonism in obstructive hydrocephalus improved after VPS in all reported cases [62][63][64]66,68], althoughonce againsome of them relapsed even after surgery [62,64,66]. As for the pharmacological treatment before surgery, levodopa was tried only in two subjects [65,67], and one patient showed a significant improvement [67].…”