Neurocysticercosis (NCC) is the commonest parasitic disease of central nervous system and an endemic problem in India. Its clinical manifestations are varied, non specifi c and pleomorphic, depending on number and topography of lesions. We report two patients of NCC, who presented only with dementia. Dementia improved in both of them, by using steroids as cerebral decongestant. Since NCC mimic large number of neurological disorders, it is important that clinicians should be familiar with these rare presentations to avoid delay in diagnosis and management. This report further suggests the utility of decongestive therapy in multiple NCC. It also heralds that dementia can sometimes be a reversible syndrome, if diagnosis and its etiology is established early and correctly.

A 30 year old male presented with insidious onset of painless swellings in tendons over 20 years, with learning difficulty, tremors, progressive instability of gait and frequent falls. There was no similar illness in family. On examination, there was firm, non tender, nodular swelling Achilles, patellar and tricep tendon, clubbing of fingers. The Mini Mental Status Examination score was 16/30. Plantar response was extensor. There was cerebellar signs with nystagmus, truncal titubation, ataxic gait and intentional tremors. Cranial MRI showed bilateral hyperintensities in dentate nucleus, globus pallidus, periventricular white matter on FLAIR/T2 sequences, and diffuse cerebral and cerebellar atrophy. The patient was diagnosed as having cerebrotendinous xanthomatosis based on the clinical and radiological features. As cerebrotendinous xanthomatosis benefit from therapy and progress of the disease is preventable, the case illustrates the need for early diagnosis.