Coexistent Japanese encephalitis and Neurocysticercosis.

A solitary cyst of NCC in the vesicular stage is observed in the left posterior frontal lobe. A tiny scolex is seen within the cyst. Perilesional edema is noted.

Increased T2 signal is observed in thalami on both sides (L > R).This is s/o Japanese encephalitis.

 

Co – occurrence of JE and NCC is not just a chance coincidence. An increased incidence of intestinal helminthic infections has been observed in patients with viral encephalitis in endemic areas. Both Japanese encephalitis (JE) and neurocysticercosis (NCC) share some common socio-demographic and ecological factors and have the same intermediate host (pig).

Sudden clinical deterioration of a patient with NCC should warrant a search for co-existent JE.  

The characteristic MR findings of JE  include bilateral thalamic hyperintensities.