Neurocysticercosis

How is the Disease Spread?

Neurocysticerosis is a parasitis disease casued by the inigestion of the eggs of Taenia
solium (pork tape worm), it is a form of Taeniasis, and is a result of the infection
travelling to the brain. It is spread by the ingestion of infected pork or sharing of
bodily fluid with an already infected person. In developing countries,
neurocysticercosis is the most common parasitic disease of the nervous system and is
the main cause of acquired epilepsy and is often called the silent epidemic.
Symptoms
Symptoms for Neurocysticercosis usually vary according to where the cysts are
located in the brain. The most common symptoms are:

Epilepsy

Headache, dizziness

Stroke

Neuropsychiatric dysfunction

Abnormal symptoms, which have been recorded, include:

Cognitive decline

Dysarthria

Extraocular movement palsy or paresis

Hemiparesis or hemiplegia, which may be related to stroke, or Todd paralysis

Hemisensory loss

Movement disorders

Hyper/hyporeflexia

Gait disturbances

Meningeal signs

Treatment and Management

Treatment is usually targeted to manage the symptoms of the disease if the parasite is
dead, this treatment includes:

Anticonvulsants

Monotherapy

If the parasite is still active the treatment is:

Patients with vasculitis, arachnoiditis, or encephalitis: A course of steroids or

immunosuppressants is recommended before the use of anticysticercal drugs

Antiparasitic treatment with albendazole is also useful in cysticercosis of the

racemose type (ie, multiple cysts in the basal cisterns)

Patients with parenchymal, subarachnoid, or spinal cysts and without

complications (eg, chronic epilepsy, headaches, neurologic deficits related to
strokes, and hydrocephalus): anticysticercal treatment can be considered, with
the concomitant use of steroids

Multiple trials with anticysticercal treatment may be required for giant

subarachnoid cysts

Patients with seizures due to viable parenchymal cysts: antiparasitic therapy

Surgical intervention is required to remove the cysts if:

Hydrocephalus due to an intraventricular cyst: Placement of a ventricular

shunt, followed by surgical extirpation of the cyst and subsequent medical
treatment.

Multiple cysts in the subarachnoid space (ie, the racemose form): Urgent
surgical extirpation

Obstruction due to arachnoiditis: Placement of a ventricular shunt followed by

administration of steroids and subsequent medical therapy.