Neurocysticercosis

Neurocysticercosis is a specific form of the parasitic disease cysticercosis that is caused by the infection of the central nervous system by the larvae of the Taenia solium (pork tapeworm). This disease is considered the most common parasitic infection of the nervous system and is a major cause of acquired epilepsy worldwide.

Epidemiology

Neurocysticercosis is most commonly found in areas where pigs are raised and where sanitation practices are poor, such as in many parts of Africa, Central and South America, and Asia. However, due to increased travel and immigration, the disease is now also seen in Europe and North America.

Pathophysiology

The life cycle of the Taenia solium involves humans as the definitive host and pigs as the intermediate host. Humans acquire the infection by ingesting undercooked pork that contains cysticerci. The cysticerci then develop into adult tapeworms in the human intestine. The tapeworms produce eggs that are passed in the feces. If these eggs are ingested by pigs, they hatch into larvae in the pig's intestine and then migrate to the pig's muscles, where they form cysts. Humans can also become infected by ingesting the eggs directly, either from contaminated food or water or from poor hand hygiene. In this case, the eggs hatch into larvae in the human intestine and then migrate to various tissues, including the brain, where they form cysts.

Clinical Presentation

The symptoms of neurocysticercosis can vary widely and depend on the number, size, and location of the cysts. Common symptoms include headaches, seizures, and neurological deficits such as weakness, numbness, or visual disturbances. In severe cases, the disease can cause hydrocephalus, meningitis, or stroke.

Diagnosis

The diagnosis of neurocysticercosis is usually made by a combination of clinical findings, imaging studies, and serological tests. Computed tomography (CT) and magnetic resonance imaging (MRI) can show the cysts in the brain. Serological tests can detect antibodies to the parasite in the blood.

Treatment

The treatment of neurocysticercosis involves a combination of antiparasitic drugs, corticosteroids, and, in some cases, surgery. Antiparasitic drugs such as albendazole or praziquantel are used to kill the cysts. Corticosteroids are used to reduce the inflammation caused by the dying cysts. Surgery may be needed to remove large cysts or to relieve increased pressure in the brain.

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