Preeclampsia is a common diagnosis during pregnancy. The symptoms of neurocysticercosis are similar to precclampsia. A misdiagnosis can be deadly for both the mother and baby. It is important for healthcare providers to recognize the subtle differences and provide appropriate treatment.

Case:

A 30 year old Gravida 1 at 22 weeks was admitted to the hospital for increasing nausea and vomiting for the past two weeks. She had a four pound weight loss since the beginning of her pregnancy. She stated she had a mild heachache and occasional white spots in vision with her headache. She had no other complaints. Her vital signs on admission were Temperature 98.1, Blood Pressure 111/61, Pulse71, Respirations 16, and Fetal Heart Rate 140. Her physical exam was normal. She had multiple labs ordered to rule out causes for hyperemesis.

Her laboratory values came back inclusive for causes for hyperemesis or preeclampsia. Her headaches and vision changes continued to progress along with her nausea and vomiting. The perinatology team ordered a CT scan to assist in determining the cause for her symptoms. The CT showed moderate hydrocephalus. The perinatology team consulted with the neurologist. The neuro exam found her pupils to be large, but reactive. Her speech was clear and moved all four extremities equally. The neurologist ordered a MRI to assist in determining the cause for they hydrocephalus. The results of the MRI found a cystic mass consistent with neurocystercosis.

This diagnosis brought a multidisciplinary team of Perinatologists, Neurosurgeon, Neurologists, Infectious Disease physician and nursing together to determine the best plan of care for this patient. The patient was transferred to the Neuro ICU for closer monitoring of her neuro status with daily assessment of her fetus by the obstetrical nurses. After much collaboration, the patient was able to be treated to decrease the pressure of the hydrocephalus and kill the parasite. The patient was transferred out of the ICU and eventually home. Due to the patients psychosocial needs, case management was involved in assisting her transition to discharge. The medications were costly and she needed assistance her follow care.

Conclusion:

Nursing was integral throughout this process. The patient was concerned for her pregnancy. The Obstetrical nurses were able to focus on her needs of her pregnancy and the Neuro nurses were able to focus on her medical and neurological needs.

Keywords:

 neurocysticercosis, preeclampsia, collaboration