Neurocysticercosis presenting as depression

Neurocysticercosis (NCC) commonly manifests as neurological symptoms, including seizures. Psychiatric manifestations also occur frequently, the most common presentation being depression. Causes include underlying inflammation due to degeneration of viable cysts, psychological burden of being diagnosed with NCC, and vigorous treatment procedures, including recurrent admissions. In this article, we report the case of a young adult female who initially manifested with only depressive symptoms in the absence of any significant stressor, not responding to antidepressant treatment, later developing recurrent uncontrolled seizures, and eventually being diagnosed with NCC using neuroimaging and serological tests. Treatment of NCC with albendazole and steroids, along with levitiracetam to control seizures, followed by re-institution of antidepressant paroxetine, led to complete remission of her symptoms. Literature is available for cases of NCC where psychiatric symptoms occurred concurrently, or after the onset of seizures, whereas the case reported here initially presented solely with depression, which makes it unique, and difficult to diagnose. The case described here is a reminder for clinicians regarding the importance of detailed history taking and ruling out organicity before making a psychiatric diagnosis.