A young male 34 yrs old who is a Engineer by profession presented with GTCS for the first time....He was in post ictal phase during admission....MRI brain was done....What could be the possible differentials in this case and the approach to this patient



Multiple calcified granulomatous lesion scattered throughout the brain. Neurocysticercosis / Tuberculoma/ Metastatic lesions in brain etc. Immunoglobulin tests for TB and cysticercus. X-ray Chest, complete CSF study, try to find out any primary carcinomatous lesion.

Mri brain is showing lesions in multiple areas few are faint while few are dense calcified . Hemogram shows leucocytosis tlc is more than 16000 polys are moreionic balance is disturbed hypokalamia and hypocalcimia.d/d pyogenic meningitis or neurocystosarcosis

Multiple lesion seen in mri.....d/d...tuberculoma....meningitis...cesticercosis....lp and.....xray chest...cbnaat...advised...plus..tlc..is...high..pyogenic....may be possible....histry suggestion is must

Start sky appearance suggestive of neurocysticercosis.Adv csf exam & look for cysticercal antibodies.

Cysticercal antigen

Also alcohol withdrawal syndrome

Electrolyte disturbance cva

loo%-Sure- But what is the final diagnosi:S . And response to the treatment.

Agreed with Dr.Sunita k

Neurocysticercosis D/d tubercular cavities/ abscesses Fungal abscesses Anti edema / convulsants Cxr, csf, immune status, blood sugars,stool for ova/ cysts, immunological tests for neurocysticercosis/ tuberculosis/ fungal

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Rule out trauma metabolic causes, space 0ccpying lesion , Cysticercosis if the brain , metastatic lesion of the brain,infective pathology like tuberculoma of the brain

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