Refractory Neurocysticercosis Requiring Etanercept: A Case Report and Review of Literature

case of tuberculosis (TB).There was no history of blurring of vision, squint, deviation of face, nasal twang of voice, or nasal regurgitation, weakness of any limb, or swaying of the body.The child was a term delivered child with an uneventful perinatal history.He achieved ageappropriate developmental milestones and was studying in nursery class.The child's family followed a vegetarian diet, and the child was fully immunized as per the National Immunization Schedule.Examination of the child revealed stable vital parameters, absence of any pallor, icterus, clubbing, lymphadenopathy, pedal edema, or any neurocutaneous markers.Anthropometry revealed a typical growing child with weight (20 kg, +0.6 Z score), height IntroductIonNeurocysticercosis (NCC), caused by the larval stage (cysticercus) of Taenia solium tapeworm, is the most common parasitic infection of the central nervous system (CNS).In the developing world, NCC has been identified as the most common cause of active acquired seizures (26.3-53.8%). 1 Most cases of seizures due to NCC are well controlled on antiseizure medications (ASMs), but some cases of refractory NCC have persistent epilepsy with headache and respond only to immunomodulatory therapy.We present a case of a 5-yearold boy with headache, vomiting, and seizures with ring-enhancing lesions and perilesional edema in the brain managed with various immunomodulatory agents, finally responding to anti-tumor necrosis factor-α (TNF-α) therapy. case descrIptIonA previously healthy 5-year-old boy presented with complaints of headache for 1 month, vomiting for 2 weeks, and an episode of right focal seizure with impaired consciousness on the day of presentation.The headache was diffuse, insidious onset, dull aching in character, nonradiating, aggravated in the early morning and with activity, present throughout the day, moderate in intensity, accompanied by nausea and vomiting, and occasionally relieved with oral analgesics.Vomiting was nonbilious, projectile, and contained food particles, with 3-4 episodes per day.For these complaints, the child was consulting a private practitioner and was consuming some oral medications, including analgesics.The seizure was characterized by sudden onset, deviation of eyes to the right side, with tightening of the right arm and leg, lasting 10 minutes, followed by drowsiness for 10 minutes.There was no history of fever, altered sensorium, rash, ear discharge, head injury, previous seizures, previous episodes of headache, weight loss, loss of appetite, or any contact with a 1,