Diagnostic Dilemma

Neurocysticercosis


Author:
Question
A 4-year-old girl born of non-consanguineous marriage presented with complaints of not flexing her left leg for 3 days. She was diagnosed as a case of neurocysticercosis 1 week ago when she had a left focal convulsion and a CT brain had shown a right high frontal ring-enhancing lesion with scolex and without any abnormal cerebrospinal fluid (CSF) finding. She was on treatment for the same with albendazole, carbamazepine, and steroids. She had received a DPT vaccine on the left thigh 3 days back.

What is the cause of her leg problem?
Expert Opinion :
The cause of her leg problem is the DPT vaccine on the left thigh. The child has presented with a history of not flexing the left leg and not a history of not being able to walk on that leg. DPT vaccine is given on the anterolateral aspect of the thigh and it can cause pain at the tensor fasciae late. On flexing the knee, the tensor fasciae late contract, and there may be a pain at the needle stick site.
This child had neurocysticercosis on the right frontal lobe. Thus aggravation of this lesion may lead to seizures and not a weakness in the left leg. The left leg area is represented in the temporal lobe of the motor cortex and thus neurocysticercosis is not a cause of the problem.
On examination, the child was able to flex the leg but complained of pain at the DPT site on flexing. Tone, power, and deep tendon reflexes were normal.
Answer Discussion :
S
Shanthi Ananthakrishnan
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Could be related to injection since she is having symptoms only after receiving the injection. Less like;y due to neurocysticercosis
2 Days ago
G
Gladys Yonah
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the frontal lesion
13 Days ago

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