Cerebral sparganosis: case report.

A 19-year-old man visited our hospital following an attack of general tonic-clonic convulsion. Multiple lesions were noted over bilateral frontal areas on brain computed tomography and magnetic resonance images. The diagnosis was confirmed by positive antibody for sparganum using enzyme-linked immunosorbent assay (ELISA). Praziquantel, 2400 mg/d for one month, was prescribed before the antibody test results came out and the treatment failed. Total removal of the lesion and the enclosed parasite cured the patient. Although the features of cerebral sparganosis on brain computed tomography and magnetic resonance images have been previously described, the findings were not specific and the present case exhibited some different patterns including bilateral multiple calcifications and ventricular compression. The significance of the bilateral involvement is not known but the ventricular compression suggests that the disease was in an active stage. Imaging studies appear to only provide some clues for the diagnosis of sparganosis. Bilateral involvement may be seen as in the present case. The final diagnosis depends on pathologic or immunologic examination results. Surgical intervention either using stereotactic techniques or total removal of the lesion is the treatment of choice while antiparasitic agents are ineffective.