Nandigama Pratap Kumar 1 , Karla Ravi 2
BACKGROUND Cysticercosis is the most common parasitic infection of the nervous system caused by Taenia solium, with humans being the definitive hosts and pigs being the intermediate hosts. Cerebral involvement is more common than spinal involvement. Spinal involvement is commonly associated with the concomitant involvement of the brain, and spine is affected in 1-3% of the all cases of the neurocysticercosis. Isolated spinal cysticercosis is very rare without evidence of concomitant cranial disease and thoracic spine is commonly involved, followed by cervical, lumbar and sacral regions. Isolated cauda equina neurocysticercosis is extremely rare and only 15 cases of isolated cauda equina involvement were reported in the literature to the best of our knowledge. We present a case with isolated cauda equina involvement of cysticercosis with review of literature. METHODS In July 2016, we performed a literature search for isolated neurocysticercosis of the cauda equina with no limitation for language and publication date. The search was conducted through http://pubmed.com, a well-known worldwide internet medical address. To the best of our knowledge, we could find only 15 cases of isolated neurocysticercosis of cauda equina. We reviewed the literature with illustration of our case. We present a case of a 27-year-old female patient who presented with insidious onset of low back pain. MRI lumbosacral spine demonstrated an oblong, intradural CSF intensity cystic lesion extending from L1 to S1. With hemilaminectomy from L1 to L5, the cyst was excised totally. Histopathological diagnosis was cysticercosis. RESULTS Patient totally recovered from her pain and sensory symptoms within a week and bladder and bowel symptoms improved gradually over a period of one to two weeks. CONCLUSION Isolated cauda equina neurocysticercosis is extremely a rare cause of cauda equina syndrome and this should be considered in the differential diagnosis of cauda equina cystic lesions. These can be excised safely with good postoperative recovery.
