Organic Manic Episode: A Case Report on an Uncommon Presentation of Neurocysticercosis
Dr. Iniyan Selvamani,
Associate Professor, Department of Psychiatry, Saveetha Medical College and Hospital, Chennai-602105, Tamil Nadu, India.
Neurocysticercosis is the most commonly encountered helminthic infection of central nervous system caused by the larval stage of Taenia solium.The most common psychiatric manifestations seen in neurocysticercosis are depression, anxiety and psychosis. However, mania as a neuropsychiatric presentation is uncommon. The index case is a 34-year-old married female who presented to a tertiary medical centre with symptoms of fever, headache and dizziness for a period of 2 months. She was subjected to detailed evaluation by the Neurology Department of the institution. Magnetic Resonance Imaging (MRI) images showed cystic lesions in the right occipital lobe and in the intraventricular areas, demonstrating vesicular stage of cysticerci. She was treated with albendazole, antiepileptics and a short course of steroids and was discharged following resolution of symptoms after 2 weeks. Within days following discharge, patient started exhibiting behavioural changes suggestive of mania and was brought to the Psychiatry Outpatient Department and managed as a case of organic manic episode with mood stabilisers and antipsychotics. Patient improved symptomatically within 2 weeks and is presently being monitored on an outpatient basis. The present case shows a rare presentation of neurocysticercosis and the significance of early recognition and treatment of the psychiatric manifestations.