**Acknowledgements**

CT scan costs less; for establishing the stage of NCC, one of them are mandatory, and both are

Recently Xiao et al. [70], investigated the imaging features of NCC to provide clinicians with valuable information in the diagnosis and treatment and then investigate the imagenological features of 71 consecutive cases of NCC diagnosed by CT and MRI in 5 years time; finding parenchymal cysticerci in 53 cases (92.9%), subarachnoid cysticerci in 39 cases (68.4%), ventricular cysticerci in 13 cases (22.8%) and spinal cysticerci in 1 case; 35 cases were associated with leptomeningitis, 10 cases were with hydrocephalus and they concluded that the imaging findings of the cysticerci, including their location, numbers, cystic sizes, capsular thickness, densities and signals of the scolices, as well as the peripheral oedema, have distinct value in timely making possible diagnosis of neurocysticercosis for clinicians. Similar characteristics are found in our series [1, 7, 14–18, 33, 71–89]. Combination of SNCC and INCC in the same

Apart from CT/MRI, angiographic studies sometimes are necessary to determine the imagenological features of vascular malformations, vasculitis and occlusion of blood vessels of the brain associated with NCC. In a previous study, 15 (53%) out of 28 patients with subarachnoid cysticercosis who underwent cerebral angiography had evidence of cerebral arteritis in

In one of the patient reported by Rocha et al. [48], MRI *demonstrated several enhancing subarachnoid cysts surrounding the occluded vessels, a right parietal racemose cyst and a left temporal large infarction area. Angiographic study showed total occlusion of left middle cerebral artery and a sub-total occlusion of right middle cerebral artery.* In the second case, CT scan *demonstrated several calcifications and a left temporal infarction area. Angiographic study showed diffuse arteritis of basilar and carotid arterial system.* In the patient reported by Levy et al. [49], the MRI demonstrated the presence of enhancing subarachnoid material surrounding these occluded cerebral arteries, providing antemortem, non-invasive documentation of the inflammatory meningeal cysticercoid reaction that was presumably responsible for the occlusive arteritis causing the cerebral infarction. In this setting, CT scan and CSF examination usually support the cause-and-effect relationship between neurocysticercosis and the cerebral infarct by showing abnormalities compatible with cysticercotic arachnoiditis. Pamplona et al. [46] *reported a case of a 43-yearold woman with an eight-month history of headaches, ataxia and loss of vision. CT and MRI showed an intraventricular cyst, causing entrapment of Monro foramina and hydrocephalus, smaller cysts at subarachnoid space in temporal lobes, Sylvian fissures, suprasellar and peri-mesencephalic cisterns, and an intra-orbital cyst. Additionally, there were acute ischaemic vascular lesions on the left thalamus and corpus callosum splenium and sub-acute ischaemic lesions of both occipital lobes.* Gilman et al. [90] reported a patient who presented with a relapsed non-aneurysmal subarachnoid haemorrhage possibly associated with subarachnoid cysticercosis and the *MRI of her brain revealed a new left subarachnoid haemorrhage involving the left suprasellar cistern, inter-peduncular cistern, left ambient cistern, and again the left Sylvian fissure. Additionally, the images showed dilatation of the lateral and third ventricles, and the aqueduct of Sylvius, with obstruction caused by cysts associated with leptomeningeal enhancement of the supracerebellar cistern.* Other authors also reported similar

Without doubt, MRI is an ideal test for investigating SNCC. However, imagenological diagnosis of SNCC is usually difficult when classical MRI sequences are used [91]. Therefore, Carrillo et al. [91] evaluated the advantages of 3D MRI sequences [fast imaging employing steadystate acquisition (FIESTA) and spoiled gradient recalled echo (SPGR)] with respect to classical sequences [fluid attenuation inversion recovery (FLAIR) and T1] in visualising *T. solium* cyst in

necessary before and after the treatment [65–69].

164 Seizures

findings [43, 44]*.*

patient as described by Hauptman [69] was also found in our series.

middle size arteries (middle cerebral artery and posterior cerebral artery) [27].

We thank Prof Targonska and Dr. Anwary, radiologist from Nelson Mandela Academic Hospital, and Dr. Priya Parag and her radiologist team from Inkhosi Albert Lithuli Central Hospital in Durban, South Africa, for their co-operation.

Special thanks to Ms. Christine Tronson Benner, MPH Department of Biostatistics and Epidemiology College of Public Health, University of Oklahoma Health Sciences Center for her suggestions and corrections made in this report.
