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Beuy Joob, Viroj Wiwanitkit1,2,3 Sanitation 1 Medical Academic Center, Bangkok, Thailand, 1 Hainan Medical University, China, 2 Faculty of Medicine, University of Nis, Serbia, 3 Joseph Ayobabalola University, Nigeria E-mail: [email protected]

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Verma R, Anand KS, Sharma BB, Garg J. Neurocysticercosis presenting as Parkinsonism. Neurol India 2013;61:656-7. Cavalcanti CE. Calcified cysticerci in basal ganglia and Parkinson’s syndrome: Report of a case. Arq Neuropsiquiatr 1984;42:183-6. Cosentino C, Velez M, Torres L, Garcia HH, Cysticercosis Working Group in Perú. Cysticercosis lesions in basal ganglia are common but clinically silent. Clin Neurol Neurosurg 2002;104:57-60. Access this article online Quick Response Code:

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PMID: ***

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DOI: 10.4103/0028-3886.128361

PMID: *** DOI: 10.4103/0028-3886.128360

Received: 29-10-2013 Review completed: 18-12-2013 Accepted: 02-02-2014

Comment on: Neurocysticercosis presenting as Parkinsonism Sir, The recent report on “neurocysticercosis presenting as Parkinsonism” is very interesting.[1] A study by Verma et al. noted that their report is probably the first case series in which anatomically symmetric cysticercal lesions within basal ganglia were associated with a clinical syndrome of parkinsonism.[1] Indeed, neurocysticercosis at basal ganglion is not rare. It is apparently that the present case is not the fi rst case of basal ganglia neurocysticercosis with Parkinsonism. At least, another case was previously reported by Cavalcanti.[2] In addition, Cosentino et al. noted that basal ganglia localization is common in neurocysticercosis but it is rarely associated with clinical manifestations.[3] Therefore, it is questionable whether the present cases are only accidental concomitant findings or not.

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Received: 21-01-2014 Review completed: 27-01-2014 Accepted: 03-02-2014

Authors’ Reply Sir, We have already mentioned in the article that neurocysticercosis (NCC) associated with Parkinsonism has been previously reported and its presence in basal ganglia is not rare. However, the concomitant presence of NCC in basal ganglia associated with Parkinsonism has been reported previously once as a single case report and not series of cases.[1,3] Moreover, we are not sure whether the previously reported case had anatomically symmetrical NCC. And as we have mentioned in the letter, the location of lesion itself appears insufficient to cause any precise changes as it has been observed that NCC affects brain regions that are distant from location of the cysticerci.[4] Finally, subsequent improvement in one of the case with only cysticidal therapy further supports our stance of NCC presenting as Parkinsonism in our case.

Rohit Verma, Kuljeet Singh Anand1, B. B. Sharma2, Jyoti Garg1 Department of Psychiatry, Lady Hardinge Medical College and Smt. S. K. Hospital, Departments of 1Neurology, and 2Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India E-mail: [email protected]

Neurology India | Jan-Feb 2014 | Vol 62 | Issue 1

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