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NEUROCYSTICERCOSIS - Coggle Diagram
NEUROCYSTICERCOSIS
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DEFINITION, ETIOLOGY AND RISK FACTOR
- Neurocysticercosis (NCC) is one of the common parasitic central nervous system
(CNS) infections.
- Improperly cooked pork and eggs of the tapeworm Taenia solium, entering the
body through the feco-oral route, are the common sources of its infection.
- Humans are infected after consuming
undercooked food, particularly pork, or water
contaminated with tapeworm eggs, or through poor hygienic practices.
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TREATMENT
- Single cyst: albendazole 15 mg/kg/d for 3 days or praziquantel 30 mg/kg in 3 divided doses every 2 hours. Corticosteroids rarely needed. AED for seizures
- Mild to moderate infections: albendazole 15 mg/kg/d for 1 week or praziquantel 50 mg/kg/d for 15 days. Corticosteroids may be used when necessary. AED for seizures
- Heavy infections: albendazole 15 mg/kg/d for 1 week (repeated cycles of albendazole may be needed). Corticosteroids are mandatory before, during, and after therapy. AED for seizures
- Cysticercotic encephalitis: cysticidal drugs are contraindicated. Corticosteroids and osmotic diuretics to reduce brain swelling. AED for seizures. Decompressive craniectomies in refractory cases
- Surgery is a recommended treatment for NCC in cases of intraventricular cysts, hydrocephalus, or when the diagnosis is uncertain from neuroimaging
DIAGNOSIS APPROACH
- Anamnesis and clinical findings are important.
- Questionairre Demonstration Proglottid (QDP)
- Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) changed the diagnostic accuracy for neurocysticercosis, as they provide evidence on the number and topography of lesions and their stage of involution.
- Vesicular (viable) cysticerci appear as small and rounded cysts that are well delineated from the brain parenchyma. There is no edema or abnormal enhancement. A sizable proportion of those cysts have in their interior an eccentric hyperdense nodule representing the scolex, giving them “hole-with-dot” appearance, which is pathognomonic of neurocysticercosis.
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COMPLICATION & PROGNOSIS
- When a cyst is destroyed by cysticidal drugs, the resulting inflammatory reaction may be pathogenic, appearing acutely as a brain edema or chronically as a gliotic scar.
- Neurocysticercosis-associated epilepsy is an important cause of neurologic morbidity, and chronic epilepsy is one of the most frequent complications of neurocysticercosis. Others include headaches, neurologic deficits related to strokes, hydrocephalus and death.
- In most patients with neurocysticercosis, the prognosis is good. Associated seizures seem to improve after treatment with anticysticercal drugs and, once treated, the seizures are controlled by a first-line antiepileptic agent.
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PREVENTION
- Wash your hands with soap and warm water after using the toilet, changing diapers, and before handling food
- Teach children the importance of washing hands to prevent infection
- Wash and peel all raw vegetables and fruits before eating
- Use good food and water
- Don't eat raw food, especially meat.
