SEVERE DElMENTIA ASSOCIATED WITH NEUROCYSTICERCOSIS ANDRES ROSSELLI, MONICA ROSSEU, ALFRED0 ARDILA and BEATRIZ PENAGOS

Neurocysticercoris is a systemic infection of the CNS by the Taenia solium or cysticerca (Escobar, Nieto & Aruffo, 1983). Epileptic-like attacks are the main clinical sign, followed by various mental disorders in about 10% of the cases (Cendes & Ferreira, 1986; Grisolia & Wiederholt, 1982). Gomez, Bustamante and !Sanchez (1985) mention 8% mental changes in their Colombian studies while Ramirez et al. ( 1986) estimate a 5% incidence. In Colombia the prevalence of ~ieurocysticercosi s is 400/100,000, while in Mexico it is 2,500/100,000 (Escalante, 1977 1. The mental changes most frequently reported are: confusion, disorientation, memory loss, hallucinations, psychomotor incoordination, progressive deterioration of language ability, and mental deterioration (Cendes & Ferreira, 1986). Dixon antl Lipscomb (1961) report schizophrenic and manic-like episodes as possible initial signs of neurocysticercosis. They found only 5 cases of true dementia in 450 patients (1.1%). However, preciise descriptions of the intellectual deterioration in cysticercosis are seldom reported. It is believed that three forms of the infection many cause such damage: parenchymous cysticercosis, which affects large areas of the CNS; ventricular cysticercosis, which cause hydrocephalus by obstruction, usually at the IV ventricle; antl meningeal cysticercosis, which causes a strong inflammatory reaction with as5,ociated extensive meningitis (Escobar, Nieto & Aruffo, 1983). McCormick, Chi-Shing-Zee and Heiden ( 1982) report parenchymous cysticercosis in which more them 200 cerebral cysticerca were observed. The case described here is of a miliar cysticercosis, affecting both cortical and subcortical structures within the cerebral parenchyma.