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RCOG World Congress 2025
June 23 - 25, 2025 | ExCeL London, UK
EP.1080
An uncommon cause of seizures in first trimester of pregnancy - Neurocysticercosis
Poster Presenter
Authors
Affiliations
Part of Topic
High risk pregnancy
Background
•Seizures during pregnancy can be associated with adverse maternal and perinatal outcomes
•Neurocysticercosis(NCC) is an unusual cause of seizures in pregnancy, which poses a diagnostic dilemma due to intriguing clinical picture mimicking toxemia of pregnancy and brain tumor
Objective
To understand possible causes and evaluation of seizure in first trimester of pregnancy
Case
•30 years, G5P2L2A2 at 10+6 weeks presented with history of 2 episodes of GTCS, associated with tongue bite, up rolling of eyes and postictal confusion
•No history of fever/headache/vomiting /altered sensorium/hypertension
•On examination she was conscious and oriented to time, place and person
•BP was 110/70 mmHg
•No focal neurological deficits
Investigations
•CBC/LFT/RFT – normal
•ECG/Echo – normal
•Fundus examination – no papilledema
•MRI brain- T2 FLAIR - Hyperintense lesion with central dot like T1 intermediate and T2 hypodensity (Figure 1) within significant perilesional edema in right parietal lobe (Figure 2) suggestive of neurocysticercosis more than tuberculoma
Provisional Diagnosis & Evaluation
•An infective etiology of NCC or Tuberculoma was suspected
•Fundus examination – no retinal cysticerci or choroid tubercles
•Chest Xray – normal
•ESR- 32mm/hr
•Stool examination: No ova or cysts
•Sputum CBNAAT and ZN stain negative for TB
Final Diagnosis : Neurocysticercosis
Management
•Neurology opinion was sought and was advised to continue on oral Levetiracetam 500mg BD
•Patient reported no further seizure episodes
•She was discharged in stable condition from the hospital
Discussion
•NCC in pregnant women can be asymptomatic or can present as headache, altered mental status, seizures, nausea and vomiting
•NCC is parasitic infection caused by larval form of pork tape worm Taenia solium, acquired by ingestion of contaminated food or water with eggs (feco-oral route)
Conclusion
•izures in pregnancy are due to a myriad of including underlying structural or metabolic causes
•NCC though an unusual cause for seizures in pregnancy, should be considered in the differential diagnosis in endemic countries like India
•A multidisciplinary approach involving neurologist, radiologist, obstetrician and physician is necessary to optimize outcome
•A high index of suspicion along with neuroimaging helps in prompt diagnosis and further management