[Isolated intracerebral XXXX . Unusual presentation of a rare disease].

@entity1 @entity3753 @entity410 @entity5409 @entity7241 @entity8434 @entity12047 @entity4801
HISTORY AND CLINICAL FINDINGS: A 46-year-old @entity1 was admitted with a first generalised tonic-clonic @entity410 . Past medical history was unremarkable. She reported no travels abroad within the past five years. INVESTIGATIONS: Brain MRI demonstrated disseminated cerebral and cerebellar focal lesions. Cerebrospinal fluid analysis showed a mild eosinophilic pleocytosis. Extensive imaging investigations and serological tests revealed no hints for a systemic @entity4801 . A stereotactic brain biopsy detected no pathogenic agent. 10 months following the initial admission, brain MRI showed multiple @entity5409 with ring-like enhancement following @entity7241 administration. At that time serological tests were positive for an infection with @entity12047 . DIAGNOSIS: The diagnosis was based on positive sequential serological tests and the typical MRI findings in conjunction with an eosinophilic cerebrospinal fluid pleocytosis. TREATMENT AND CLINICAL COURSE: An antihelmintic therapy with @entity3753 was initiated. Following two-months of oral @entity3753 administration, brain MRI revealed a clear reduction in size and number of the hydatid lesions. The @entity1 was free of complaints and the clinical examination was unremarkable. CONCLUSION: Isolated intracerebral manifestation of @entity8434 is very rare. Compared to the typical presentation with a solitary cerebral hydatid cyst, the dissemination of hydatid cysts is quite uncommon in @entity8434 . Diagnosis should be based on the typical MRI findings and serological tests. The present case demonstrates that the later may be negative over a long period within the clinical course of the disease offering a real challenge to the clinician.
