Neurocysticercosis presenting as postpartum psychosis: a case report on challenging clinical insight with review of the literature.

INTRODUCTION

Postpartum psychosis (PPP) is a psychiatric emergency with symptoms such as mania, depression, hallucinations, and delusions appearing shortly after childbirth. Neurocysticercosis (NCC), a CNS infection from Taenia solium, can also manifest psychiatric symptoms, complicating diagnosis. This report discusses a rare case of NCC presenting as PPP, emphasizing diagnostic complexities and the need for a multidisciplinary approach.

CASE PRESENTATION: A 23-year-old female presented with psychotic symptoms 15 days postpartum, initially treated for PPP with lorazepam, olanzapine, and haloperidol. Following the development of generalized seizures, neuroimaging revealed NCC lesions. Treatment with albendazole and steroids led to symptom resolution.

DISCUSSION: This case highlights NCC's rare presentation as PPP. A thorough evaluation is crucial, as PPP poses risks to both mother and infant. In regions where NCC is endemic, psychiatric presentations due to this infection create diagnostic challenges, especially in limited-resource settings. Neuroimaging is vital for precise diagnosis, and early intervention with a multidisciplinary team enhances outcomes.

CONCLUSION

The case underscores the complexity of PPP diagnosis and management when coexisting with NCC. Clinicians in endemic regions should consider NCC in postpartum women with atypical psychiatric symptoms, ensuring appropriate investigations. A multidisciplinary approach involving psychiatry, neurology, and radiology is essential for effective management.