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Trichinella encephalitis remains a rare but life-threatening illness. Although well known to clinicians of another era, this disease currently may represent a diagnostic dilemma because of its infrequent occurrence and varied presentations. This report of trichinella encephalitis, presenting as quadriplegia, demonstrates that technological advances such as CAT scan, angiogram, and EEG are of no diagnostic assistance and add nothing to traditional diagnostic modalities, i.e., eosinophilia, sedimentation rate, and muscle biopsy. In some cases of trichinosis encephalitis where hypersensitivity reaction and/or vasculitis is believed to be the inciting factor, cortical steroids may have a role in treatment.