Spinal racemose cysticercosis: case report and review

Cysticercosis is a common helminthic infection worldwide, endemic in Central and South America, sub-Saharan Africa, and Southeast Asia. Neurocysticercosis typically involves brain parenchyma, subarachnoid space, and the ventricular system. Although the spinal cord is frequently involved in patients with parenchymal neurocysticercosis, isolated spinal involvement is rare, occurring in only 1–3% of patients. We report a case of racemose spinal neurocysticercosis with brain parenchyma involvement in a 49-year-old Mexican man, who presented with unsteady gait and bilateral arm numbness and weakness. Magnetic resonance imaging revealed multiseptated cystic lesions in the upper cervical spinal canal and nonenhancing intradural extramedullary cystic lesions in the thoracic spine. The patient underwent sub-occipital craniectomy with decompression, followed by a course of steroids and albendazole. Pathology confirmed the diagnosis of neurocysticercosis, and the patient’s symptoms resolved after treatment. We include discussion on the symptoms, diagnosis, and treatment of neurocysticercosis with a focus on the spinal form.