Neurocysticercosis and Psycho-Social Trauma

Aims: This paper describes a patient with neurocysticercosis who presented with psychotic features that related to his experiences of civil unrest in Rwanda.
Study Design: A review of the literature on neurocysticercosis is described and the history of genocide in Rwanda in 1994 is summarised. The case of an African refugee to Australia is presented.
Place and Duration of Study: Cairns Base Hospital between 13 June 2011 until 21 July 2011 and then follow up in the community until the end of October 2011.
Methodology: The patient was admitted through the Emergency Department where he was assessed and treated in a medical ward with the involvement of the Psychiatric Liaison Team and Infectious Disease Team. CT and MRI of the brain confirmed the diagnosis of neurocysticercosis. Medical treatment was administered for neurocysticercosis and a subsequent epileptic seizure. Psychiatric treatment and community psychiatric and medical follow-up were undertaken.
Results: Medical treatment of neurocysticercosis was successful but the patient subsequently developed a seizure disorder that was treated effectively. The patient’s psychotic disorder was treated with medication and supportive psychotherapy. Unresolved grief related to psycho-social trauma was addressed on an on-going basis during his community treatment.
Conclusions: Neurocysticercosis is disorder that should be considered in immigrants from countries that have endemic neurocysticercosis. A small minority of patients present with psychosis (14%). This patient presented with psychosis that reflected his psycho-social trauma.