Neurocysticercosis Flashcards
Neurocysticercosis - transmission
Ingestion of T solium eggs
Neurocysticercosis - organism
Taenia solium
Neurocysticercosis - epidemiology
Prevalent in wide regions of world:
-Central and South America, East Europe, Asia, Africa
Main cause of acquired epilepsy in developing countries
Neurocysticercosis - clinical presentation
Any neurological symptom - mainly late onset epilepsy
Most frequently:
-Seizures [parenchymal]
-Chronic headaches
-Intracranial hypertension [extraparenchymal]
Ocular:
-Can be freely floating in vitreum
Muscle calcifications:
-Cigar shaped calcifications
Neurocysticercosis - CNS location
Intraparenchymal:
-Cysts - granuloma - calcification
-Variable evolution and presentation
-Cysticercotic encephalitis = disseminated CNS with high level of inflammation, more common in women
Extraparenchymal:
-Subarachnoid [racemouse] cysts
-Can cause intracranial hypertension, hydrocephalus
-Uncontrolled growth of cystic membrane when extraparenchymal
Neurocysticercosis - diagnosis
Imaging - CT/MRI
Serology:
-Western blot = antibodies to 7 LLGP antigens, not widely available
-ELISA = not widely available
Molecular:
-Parasite DNA from serum, CSF and urine
-Sensitivity in parenchymal not yet known
Neurocysticercosis - novel diagnostic methods
Synthetic Western blot - MAPIA
Dipstick antigen detection assay
Neurocysticercosis - treatment for viable parenchymal disease
Anti-parasitic agents:
Albendazole 10 days
Praziquantel 10 days
Neurocysticercosis - treatment for cysticercal encephalitis
Avoid anti-parasitic drugs - treat cerebral oedema with corticosteroids
Neurocysticercosis - treatment for calcified NCC
No need for anti-parasitic treatment
Neurocysticercosis - treatment for interventricular NCC
Endoscopic exeresis where available
Open surgery or albendazole + steroids
Neurocysticercosis - basal/subarachnoid NCC
Albendazole + steroids - longer courses
Probable need for VP shunting
