[A case of neurocysticercosis suggestive of a reinfection, 20 years after the initial onset].

A 70-year-old man, who had frequently visited the Southeast Asian countries as a tour conductor, presented convulsion as an initial symptom twenty years ago. A diagnosis of neurocycticercosis was made by a stereotactic brain biopsy. Thereafter, anticonvulsant therapy was initiated, and he continued his travelling without any troubles. After travelling to Philippines, he suffered high-grade fever and consciousness disturbance, and his general status deteriorated. His consciousness level was evaluated as Japan Coma Scale 3 and his status was bedridden on admission to our hospital in December 1999. Anti-cysticercus cellulosae antibody was clearly detected both in his serum and cerebrospinal fluid (CSF). An MRI brain scan revealed disseminating lesions showing ring enhancement after administration of gadolinium-DTPA both intra and extra brain parenchyma. Steroid therapy and a cysticidal therapy relieved his symptoms, and CSF and MRI findings. Because it may be impossible for the cysticercosis cellulosae to be latent in the central nervous system as long as 20 years and to be reactivated, the reinfection of cysticercus cellulosae was supposed to be the cause of his symptoms.