When the Past Catches Up: A Case of Latent Neurocysticercosis Presenting With Seizures

Neurocysticercosis (NCC), a central nervous system infection caused by the larval form of Taenia solium, remains one of the leading causes of acquired epilepsy worldwide, particularly among individuals from endemic regions. We describe a 41-year-old man originally from Guatemala who presented with new-onset generalized tonic-clonic seizures nearly 20 years after immigration to the United States, without recent travel or new exposure risks. Brain imaging demonstrated multiple calcified lesions and peripherally enhancing cystic structures consistent with NCC. This case is distinctive due to the prolonged latency between presumed exposure and symptom onset, as well as a seronegative presentation in which diagnosis relied primarily on characteristic neuroimaging findings. The report underscores the importance of detailed epidemiologic history-taking and maintaining diagnostic vigilance for parasitic infections when evaluating new-onset seizures after remote exposure.