Cerebral sparganosis is a rare disease caused by sparganum infection in CNS.  We present a case which presents status epilepticus with cerebral sparganosis that was diagnosed by ELISA for sparganosis in serum and CSF; however, brain MRI shows no structural lesion.

A 20-year-old man complained of headache for three days. He subsequently developed mental confusion which brought him to the emergency room. He had a generalized seizure lasting for 3 minutes on arriving the emergency room. There were no structural lesions on Brain CT and MRI. The CSF findings presented pressure 37cmHg, turbid and white color, WBC 20/mm^3, protein 973.9mg/dL and other laboratory findings were negative. The continuous seizures occurred 4 hours after the first attack and stopped with continuous infusion of 30mg of midazolam every hour. On admission day, the continuous EEG monitoring revealed continuous multifocal 1 Hz repetitive spikes which migrated and moved around right frontal, left frontal, right temporal areas, while the patient was showing no clinical seizure. Consecutive EEGs for 7 days showed ictal discharges of repetitive focal spikes with foci continuously moving around. After 1 weeks, the IgG antibody ELISA test of serum and CSF for parasitic infection confirmed positive for sparganosis in both CSF and serum. The follow-up brain MRI with enhancement revealed no abnormal lesion in brain parenchyma. Praziquantel was administered at a dose of 25 mg/kg three times daily for 10 consecutive days based on the diagnosis of cerebral sparganosis. And then the patient could respond to verbal command. The follow-up CSF profiles were within normal limit in chemistries and immunological studies, including ELISA test for parasitic infection.

We report the patient with cerebral sparganosis, which was diagnosed based on the serum and CSF ELISA test for sparganum, not having brain lesions on MRI and subsequently treated with Praziquantel.