Neurocysticercosis: do not miss the eye
The present case has been reported in BMJ.

A 6-year-old girl presented with new-onset left focal seizures, and was started on valproate. There was no history of fever, headache, visual deficit and neurological examination was completely normal. Neuroimaging revealed ring enhancing lesion in the right parietal lobe.

Ocular examination revealed visual acuity of 6/6 in both eyes, with no evidence of uveitis or other abnormality of the anterior segment. Fundus examination revealed hypopigmented area in left retina midway between fovea and optic disc.

Optical coherence tomography (OCT) using Spectralis HRA-OCT revealed presence of scolex beneath the retinal pigment epithelium.

The Child was started on oral prednisolone and albendazole, and a 28-day course was completed. Repeat OCT revealed resolution of the scolex and neuroimaging showed disappearance of the ring-enhancing lesion.

Learning points
• Ocular examination is of paramount importance in neurocysticercosis.

• Optical coherence tomography can diagnose lesions better with better resolution.

Source: http://casereports.bmj.com/content/2018/bcr-2018-227869.full
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