Abstract
Neurocysticercosis (NCC), caused by the larval stage of Taenia solium, is a parasitic infection of the central nervous system (CNS) that is increasingly identified in non-endemic regions due to global migration, while intraventricular and subarachnoid manifestations, especially those associated with frontal lobe involvement, remain underrecognized. This case report describes a 16-year-old immigrant who presented with psychotic and mood symptoms consistent with schizoaffective disorder, including hallucinations, suicidal ideation, and behavioral dysregulation managed by agitation. Neuroimaging revealed a right frontal lobe cyst with surrounding edema. The lesion with location and vesicular phase informed a treatment plan involving albendazole, corticosteroids, and long-acting antipsychotics. The patient's psychotic symptoms improved significantly following antiparasitic therapy and initiation of long-acting antipsychotic treatment. This case highlights the neuropsychiatric impact of frontal lobe NCC and underscores the importance of integrating neuroimaging, psychiatric evaluation, and targeted treatment in immigrant populations presenting with atypical psychiatric syndromes.