Thousands of Lesions in Disseminated Cysticercosis

Human cysticercosis is an important cause of seizures in the developing world. A small subset of patients acquires heavy infections with large numbers of lesions disseminated throughout the brain and skeletal muscle. 1 Manifestations of heavy multiple cysticercotic syndromes include cysticercal encephalitis or signs and symptoms related to location. A 30-year-old man presented with intermittent partial complex seizures and headache for the previous 2 years. Examination revealed widespread small pea-sized nodules throughout the body, including the tongue ( Figure 1 ). Calf hypertrophy was present ( Figure 2 ). Higher mental function, cranial nerves, and motor, sensory, and reflexes were normal. An enzyme-linked immunsorbent assay for Taenia solium antibody was positive at high titers. A T2 sagittal magnetic resonance image of the brain showed numerous circumscribed lesions with visible scolices and involving adjacent soft tissues ( Figure 3 ). Cysticercosis is caused by the cestode larvae of the pork tapeworm T. solium . Disseminated cysticercosis has the potential to cause severe clinical manifestations. 2