Cerebral Paragonimiasis Presenting with Dementia

Abstract

We report a case of an 80-year-old Korean man with chronic cerebral paragonimiasis who presented with progressive memory impairment. He suffered from pulmonary paragonimiasis 60 years ago and has been experiencing epilepsy since the age of 45. He began experiencing memory and cognitive deterioration 3 years ago. He visited the neuropsychiatric department of our hospital to check his symptoms and health from a year ago. Contrast-enhanced brain magnetic resonance imaging study revealed calcifications and cystic lesions encompassing the right temporo-occipital region. Encephalomalatic changes were also observed in the right occipital and temporal areas. The anti-Paragonimus specific IgG antibodies in his serum showed a strong positive response. The neuropsychological test results showed a Global Deterioration Scale of 4 and a Clinical Dementia Rating Scale of 1. The chronic cerebral paragonimiasis lesions in the patient's right temporo-occipital region might induce the dementic change.

Keywords: Paragonimiasis; cerebral paragonimiasis; cognitive impairment; dementia.

Fig. 1

Horizontal (left) and coronal view (right) of brain MR image of an 80-year-old man who presented with dementia. Complicated cystic structures and calcifications (circles) are seen mainly in the right occipital lobe, with encephalomalasias in the right occipital and temporal lobes.