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Dr. Andrew Rynne

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Lesion In The Cerebellum. Do I Have Cysticercosis Or Multiple Sclerosis?

Dear Dr. Keerthi, my neurologist has found only one lesion in my cerebellum , left side, 9.9 mm in size. He suggested it is possible that I have cysticercosis , but I wonder if these lesions can sometimes be confused with multiple sclerosis lesions. I have not traveled, nor have I eaten any undercooked pork. I am just confused and have so many neurological symptoms.
Thu, 14 Feb 2013
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Neurologist 's  Response
Hi,

Thank you for posting your query.

One thing we can be sure of is that you do not have multiple sclerosis (MS). In MS, as per the definition, one should have multiple lesions in various locations. Also, there are certain very specific areas affected in MS such as corpus callousum, peri ventricular areas, etc.

Regarding neurocysticercosis (NCC), it is possible with a lesion in cerebellum. I presume contrast MRI study was also done. If a scolex is seen, then the diagnosis is certain, otherwise a presumptive diagnosis of NCC can be made.

It is not necessary to eat pork or non veg food to get NCC. If the vegetarian food is contaminated with tapeworm eggs, then one can still get NCC.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant Neurologist
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General & Family Physician Dr. Luchuo Engelbert Bain's  Response
Hi,
Your neurologist certainly has particular criteria she used in making this diagnosis of cysticercosis. It has a particular apearance on the scan, and also depending on the ascernal of clinical symptoms you present, good be a good orientation.
Multiple sclerosis is a different illnesses, with very different clinical characteristics. Involvement of the cerebellum can occur, but when present, clinical, radiologic signs are really quite different and characteristic. Its really quite difficult to take cysticercosis for multiple sclerosis, for the clinical scenarios are really quite different.
However, the pas history, travel history, pas feeding habits, exposure to pock or particular risk factors for cysticercosis and certain serologic tests could be key guides in further distinguishing these two clinical syndromes.
Thanks and best regards as I pray this helps,
Luchuo, MD.
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Lesion In The Cerebellum. Do I Have Cysticercosis Or Multiple Sclerosis?

Hi, Thank you for posting your query. One thing we can be sure of is that you do not have multiple sclerosis (MS). In MS, as per the definition, one should have multiple lesions in various locations. Also, there are certain very specific areas affected in MS such as corpus callousum, peri ventricular areas, etc. Regarding neurocysticercosis (NCC), it is possible with a lesion in cerebellum. I presume contrast MRI study was also done. If a scolex is seen, then the diagnosis is certain, otherwise a presumptive diagnosis of NCC can be made. It is not necessary to eat pork or non veg food to get NCC. If the vegetarian food is contaminated with tapeworm eggs, then one can still get NCC. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist