MDadmit Cool Case of the Week Answer

Case#1: 50yo female from Eastern Europe presents to the Emergency Department with three weeks of intermittent double vision, trouble walking, and R arm uncoordination. She had an outpatient CT of her head that showed no abnormalities and could not initially undergo a MRI because she had an IUD in place. The IUD has been removed and she now presents to the EED because the symptoms are getting worse. On exam, her vital signs are stable. Positive findings include a cranial nerve III palsy of the left eye, R arm and leg ataxia, and marked gait ataxia. She also has trouble finding words. A MRI/MRA is performed emergently that shows a ring-enhancing lesion in the midbrain. What could the lesion be? What is the diagnosis?

Answer #1: Neurocysticercosis