Magnetic Resonance Spectroscopy for the Diagnosis of Unusual Case of Cystecercal Meningoencephalitis

Abstract

Neurocysticercosis (NCC) is the most common infestation of Central Nervous System (CNS) in India. CNS involvement is seen in 60–90% of all infested patients with wide variations in clinical manifestations. Here we report a case of NCC in a young female who presented as meningoencephalitis which is a very rare initial presentation of the disease. Clinical history and cerebrospinal fluid examination were more suggestive of either viral or tuberculous cause.  MRI showed only two ring enhancing lesions. Later Magnetic Resonance Spectroscopy (MRS) was done, which showed findings suggestive of neurocysticercosis.  MRS is a latest non invasive technique to differentiate two common causes of ring enhancing lesions in India i.e tuberculoma and neurocysticercosis. MRS plays a very important role when diagnostic dilemma occurs between these two conditions.