Neurocysticercosis: An Easy to Miss Diagnosis in Non-Endemic Regions

A 29-year-old male presented with swollen gums and stomatitis for the past two months. History revealed that he had moved to the United States from India six years ago and had a first episode of generalized tonic-clonic seizure with confusion and loss of consciousness. Meningioma of the brain was diagnosed, and a Gamma Knife excision of the meningioma was planned. The patient refused to proceed with the surgery and came back to India for a second opinion. Upon repeat MRI scan, the neurosurgeon revised the diagnosis to neurocysticercosis (NCC), and the patient was treated with albendazole, prednisolone, and phenytoin and recovered completely. Hence an unnecessary brain surgery was avoided. The complaint of stomatitis and gingival hypertrophy was due to the side effects of phenytoin. NCC remains a major public health problem in developing countries, and it should be considered as a differential diagnosis in patients from NCC endemic regions.