A 35-year-old man presented after a generalised tonic–clonic seizure. He had a 6-month history of intermittent headache and vertigo but no previous seizures.

An electroencephalogram showed diffuse slowing, indicating the postictal period. Axial contrast-enhanced computed tomography (CT) showed multiple cystic lesions scattered throughout the brain parenchyma, many containing dense white inclusions with a typical appearance of scoleces (tapeworm attachment organs), consistent with a diagnosis of neurocysticercosis (Figure). Serum was positive for cysticercus IgG antibodies by ELISA (enzyme-linked immunosorbent assay) (1.68 optical density [OD] units; reference range, < 0.9 OD units). Stool examination failed to show eggs of Taenia solium. There was no evidence of cysticerci in thighs, subcutaneous tissues or in the posterior segment of the eye on fundus examination.

The patient was treated with antiepileptic drugs, glucocorticoids and albendazole (15 mg/kg/day for 21 days). He remained seizure-free and was advised to have a repeat CT scan after 12 weeks.