Introduction: Japanese Encephalitis (JE) is a mosquito born encephalitis caused by Flavivirus whereas Neurocysticercosis (NCC) is parasitic disease of CNS caused by Tinea Solium. We are presenting a rare case of JE with NCC.

Case Description: A 9 year old girl presented with headache, vomiting, GTC convulsion, aphasia, altered sensorium & right side weakness since 15 days. Later she developed ataxia. Examination revealed ipsilateral right spastic hemiparesis with UMN 7^th nerve palsy. She had reduced power, brisk reflexes & extensor plantar on right side.

Her MRI Brain featured Hyperintensity in bilateral thalami & cerebral peduncle without restricted diffusion s/o JE and hyperintense ring enhancing lesion with perilesional edema in left temporal region s/o NCC, In CSF- JE virus IgM antibodies found Positive, rest CSF Examination-Normal. Child Received Inj.Dexamethasone, Inj.Acyclovir, Tab.Albendazole & supportive management. She gradually improved in form of improved sensorium & facial weakness & increased power over period of 3 weeks & complete neurological recovery seen in next 4 months.

Discussion: Theoretically both JE and NCC share some common epidemiological factors and in both conditions pigs act as intermediate carrier. Clinical presentation of children with coexistence of JE and NCC is similar to children with JE alone. It is postulated that co-infection of JE and NCC might be synergistic and not simply a coincidence. NCC predisposes a person to JE infection and also increases mortality due to JE

Conclusion: Synergistic effect of NCC in JE suggests need for control of NCC in addition to control the spread of JE.