Image 16:
This young Haitian woman presented with a 2 month history of intermittent day-long episodes of vertigo and vomiting without headache. She had had Bell's palsy a year earlier. Blood eosinophil levels were normal.
Diagnosis:
This is intraventricular cysticercosis with hydrocephalus. She had cysts in the lateral, 3rd and 4th ventricles and basalar meningitis. Her serum and CSF cysticercal Western Blot was positive as was echinococcal serology (CDC Atlanta) Multiple shunt procedures over two years always resulted within months in shunt obstruction. Prolonged albendazole and praziquantel treatements were eventually unsuccessful as were several neurosurgical evacuations of all cysts found in the lateral and 3rd ventricles. The cysts were compatible histologically with T. solium cysticeri.
