Infectious diseases: neurocysticercosis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Infectious diseases: neurocysticercosis

Sample item

A 28-year-old man from a pig-rearing community has a first generalised seizure. CT shows two small cystic lesions in the cerebral cortex, each with an eccentric dot-like scolex, and no hydrocephalus. Fundus examination is normal. What is the most appropriate management?

AEmpirical antituberculosis therapyBAlbendazole with corticosteroids and an antiepileptic drugCAlbendazole alone without steroidsDSurgical excision of both cysts

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Albendazole with corticosteroids and an antiepileptic drug

Viable parenchymal neurocysticercosis is treated with albendazole, often with praziquantel in multiple cysts, together with corticosteroids to blunt the inflammatory reaction as the larvae die, and an antiepileptic drug for seizures. The eyes are examined first because treating intraocular cysts can cause blindness. Surgery is reserved for intraventricular or obstructive lesions.

Option by option

A. Empirical antituberculosis therapy
A cyst with a visible scolex is characteristic of cysticercosis rather than a tuberculoma.
B. Albendazole with corticosteroids and an antiepileptic drug (correct)
Cysticidal drug cover with steroid and antiepileptic therapy is the standard regimen.
C. Albendazole alone without steroids
Antiparasitic therapy without steroids risks a severe inflammatory reaction and worsened seizures.
D. Surgical excision of both cysts
Small parenchymal cysts do not need surgery.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Albendazole with corticosteroids and an antiepileptic drug. Viable parenchymal neurocysticercosis is treated with albendazole, often with praziquantel in multiple cysts, together with corticosteroids to blunt the inflammatory reaction as the larvae die, and an antiepileptic drug for seizures.

Why is "Empirical antituberculosis therapy" not the answer?

A cyst with a visible scolex is characteristic of cysticercosis rather than a tuberculoma.

Why is "Albendazole alone without steroids" not the answer?

Antiparasitic therapy without steroids risks a severe inflammatory reaction and worsened seizures.

Why is "Surgical excision of both cysts" not the answer?

Small parenchymal cysts do not need surgery.

What concept does this question test?

It tests Infectious diseases: neurocysticercosis in General Medicine. The eyes are examined first because treating intraocular cysts can cause blindness. Surgery is reserved for intraventricular or obstructive lesions.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infectious diseases: neurocysticercosis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.