Cysticercosis
NATIONAL JOURNAL OF HOMOEOPATHY 1996 Mar / Apr Vol V No 2.
Mishra S C.
Cases.
` Tub.

Introduction:

Cysticercosis is referred to an encysted larvae of tape-worm (Taenia Solium) found embedded in any part of the body of infected person.

Mostly this occurs in non vegetarians but now-a-days it is found in vegetarians too, especially those who eat raw salads.

The larvae of tapeworm when ingested from infected pork, beef, fish or raw salads penetrate the intestinal lumen and being carried through the blood stream, gets embedded somewhere in the body eg. skin, muscle, periphery of heart, eye, brain or any other organ. Usually the most common site of cysticercosis is the subcutaneous tissue and skeletal muscle. When it settles in brain it gives rise to problems such as Meningo-encephalitis, neurological disturbance, loss of consciousness, epilepsy and even psychiatric manifestations.

I recently had an opportunity to deal with a case of cysticercosis in the brain.

Mrs. A Shukla age 37, a bank official, very smart yet modest and strictly vegetarian came to me on 7/11/95 with the following complaints:.

Chief Complaint: Constant mild headache.

On 7/8/95 while doing some sewing job at 9 p.m. she had sudden loss of consciousness. 3 days prior to this episode she had a mild left parietal headache after rising from bed in the morning and this headache persisted all day long except during sleep.

Past History: Typhoid, Jaundice 10 years back. Suffered from Malaria for one month at the age of 18 years, chicken pox, swelling of cervical gland.

Patient as a person: Ambi-thermal.
Appetite good. Likes sweets (3+), moderate hot food, tea hot.
Thirst 8-10 glasses a day.
Stool OK.
Menses profuse and lasts for 4 days, clotted at times.
Has 2 issues, 1st delivery normal, 2nd delivery by Vacuum. D & C 1.
Sleep very light, Slight noise leaves her wide awake. Sleeps on left side.

She prefers to remain always busy with some work and never feels fatigued even after her strenuous official and house work. She has to do every thing from marketing to cooking as her husband, being a Union leader, cannot help her at all. A few hours sleep makes her fresh and fine for the whole and she never needs rest in between. She is sober, good tempered, well behaved, does not get irritated easily and discharges her official and house hold duties very confidently without being least perturbed. She cooks, coaches her children, drops them by car to their school and brings them back when returning from office.

Family History: Father diabetic, Mother Angina, PGF diabetic.

Investigations:

1. CT Scan report (Jabalpur) of head dated 8/8/1995 reads - "There is evidence of a ring enhancement lesion (1cm x 0.8 cm), with a small hyper-dense enhancing nodule in centre and surrounding oedema in grey matter of posterior and upper region of left parietal lobe. Ventricles are normal in location and size. No evidence of sub/extradural collection.".
   
   "?Post ictal enhancement".
   
   Lesion of tuberculous granuloma or Neuro-cysticercosis with surrounding post ictal oedema in posterior and upper region of left temporal lobe.
2. MRI report (Bombay) dated 31/8/95 reads "A subcentimetre lesion is noted in the subcortical left posterior parietal lobe. It is hypointense on T1 weighted images with an eccentric isointense mural nodule. The centre turns hyperintense on T2 weighted images.

Mild degree of surrounding oedema is noted. No other focal Parenchymal lesion is seen. Ventricles are mildly prominent sulci and cisterns are within normal limits.

Conclusion: Subcentimetre cystic lesion in left posterior parietal lobe exhibiting a mural nodule with mild peri focal oedema - dying cysticercal granuloma.".

She continued her allopathic treatment but she had no. improvement in her headache. Again after some time her CT Scan of head was taken and was reported as follows:.

CT Scan of head dated 6/10/95 (Jabalpur).

"There is enhancement in grey matter of posterior and upper region of left Parietal lobe seen in previous scan 8/8/95 (1 cm x 0.8 cm) now measure 0.9 cm X 0.8 cm and the hypertense enhancing nodule in its centre had disappeared. Oedema surrounding the lesion is persistent.

No new lesion is seen any where in infra/supratentorial cerebral parenchyma. Perimesencephalic cistern is well defined. Ventricles are normal in location and size. No evidence of sub/extradural collection. Falx of cerebrum is in midline.

CT Impression:? Solitary lesion of Neurocysticercosis.? Tuberculous granuloma with perifocal oedema in posterior and upper region of left parietal lobe.".

Her clinical condition was not improvement as yet when she came to me. Her main complaints as on 7/11/95 were

1. Persistent mild headache in left parietal region after rising from bed.
2. Crawling in anus at times.
3. Some times startles in sleep.
4. Ant biting sensation all over the body at times irrespective of sun-exposure or any other stimulus.
5. Thirsty.
6. Tongue clean and moist.

TREATMENT and FOLLOW-UP: With these meagre symptoms and without any modality I started treatment with 4 doses of Thuja 200 (7/11/95) to be taken daily one in the morning and asked her to report after a week.

15/11/95: No amel in headache. Flatulence.
Carbo veg 200/4 SL 1 dr OD.
4/12/95: Still there is no appreciable amel in headache.

What should be her remedy? I only perceived her bold symptoms of being industrious, having no feeling of fatigue inspite of her hectic work days. Personal, social, moral and official duties keep her all along busy and there is no rest for her, yet she does not have any resentment, rather she is enjoying it. As if she is rocking and rocking amidst her work and duties. Is it rocking amel. (K 75)? Add to this, her worm infestation and clean moist tongue I got Cina.

4/12/95: Cina-200 six doses, one daily on empty stomach.
15/12/95: No complaints, feeling better.
Tub-b 200 one does and SL for 15 days. (Epilepsy falls in the tubercular miasm).

After this the patient did not consult me in person but reported on phone that she is keeping good health and there is no complaint. I advised her to take another CT Scan and report was NCCT and CECT of brain dated 25/1/96 (Jabalpur). As compared to previous scan the enhancing lesion seen in left temporo-occipital region has almost completely resolved and the central parenchyma reveals normal...

Impression: Resolved granuloma in left temporo-occipital region.
10/3/96: Seen the patient physically. Generally in the case of Cysticercosis there should be multiple nodular swellings in the body but the patient had no swelling nodule anywhere in her body. There is no complaint. She is taking Eptoin (for convulsions) tab daily as per her Neurophysicians advice. No seizure or fits or loss of consciousness till date. She is asked to keep contact with me for any sort of complaints hereafter.

OBSERVATION: In this case the patient was under rigorous allopathic (cystostatic and then cysticidal) treatment with very negligible effect in resolving the cysticercotic granuloma. As evident from CT Scan report dated 6/10/95, the cyst was found have resolved nominally from 1 cm x 0.8 cm to 0.9 cm x 0.8 cm within the period from 8/8/95 to 6/10/95. She then switched over to Homoeopathy from 7/11/95 and after this her clinical symptoms subsided completely and her cysticercal granuloma too was resolved completely, rendering the patient free from ailment, within short period.

(ISSUE EDITOR Dr C H ASRANI DNB; MRI report of 1/8/95 says "dying" cysticercus. That means on that day the cyst was dying. It was expected that CT of Jan 96 will show total resolution of the lesion. Tuberculomas, too, are known to disappear without treatment. As patient was taking Eptoin, Dr. S C Mishra can be given credit for relieving patients symptoms of headache.).

EDITOR DIFFERS: As Headache was the only and recent complaint of patient, it was definitely related to cysticercus. The "dying" cysticercus of 1/8/95 had shown no change in headache. So Hom. effect is conclusive. Eptoin should be tapered.