Clinical characteristics and management of neurocysticercosis patients: a retrospective assessment of case reports from Europe

Abstract

Objectives Neurocysticercosis (NCC) is a parasitic disease caused by the larval stage of the tapeworm Taenia solium. NCC mainly occurs in Africa, Latin America and South-East Asia and can cause a variety of clinical signs/symptoms. Although it is a rare disease in Europe, it should nonetheless be considered as a differential diagnosis. The aim of this study was to describe clinical characteristics and management of patients with NCC diagnosed and treated in Europe. Methods We conducted a systematic search of published and unpublished data on patients diagnosed with NCC in Europe (2000–2019) and extracted demographic, clinical and radiological information on each case, if available. Results Out of 293 identified NCC cases, 59% of patients presented initially with epileptic seizures (21% focal onset); 52% presented with headache and 54% had other neurological signs/symptoms. The majority of patients had a travel or migration history (76%), mostly from/to Latin America (38%), Africa (32%) or Asia (30%). Treatment varied largely depending on cyst location and number. The outcome was favorable in 90% of the cases. Conclusions Management of NCC in Europe varied considerably but often had a good outcome. Travel and migration to and from areas endemic for Theridion solium will likely result in continued low prevalence of NCC in Europe. Therefore, training and guidance of clinicians is recommended for optimal patient management.

Knowledge and misconceptions about epilepsy among people with epilepsy and their caregivers attending mental health clinics: A qualitative study in Taenia solium endemic pig‐keeping communities in Tanzania

“…solium eggs, with wide variation across regions 6–9 . NCC manifests in many ways, but most commonly with epileptic seizures or severe progressive headaches 10–12 …”

Epidemiological, clinical and radiological characteristics of people with neurocysticercosis in Tanzania–A cross-sectional study

“…[2] Epileptic seizures are the most common clinical characteristic, especially among patients with lesions in the parenchyma. [3] In areas highly endemic for T. solium up to one third of acquired epilepsy is caused by the parasite. [4][5][6] In contrast, patients with lesions in the extraparenchymal space (e.g.…”

Characteristics of people with epilepsy and Neurocysticercosis in three eastern African countries–A pooled analysis

“…Furthermore, even where available, serological tests for the diagnosis of T . solium NCC only have limited accuracy, particularly for single lesions and lesions located in the extraparenchymal space for which the tests often are false negative [ 6 ]. For this reason, most people with NCC in sub-Saharan Africa have unfortunately been diagnosed only in the context of scientific research projects and not in the general health care system.…”

“…NCC is a poverty-associated classical One Health disease and seldomly diagnosed because of lack of awareness among medical personnel, limited diagnostic facilities in endemic areas, costly diagnostic tests, and lack of One Health disease surveillance at the community level, where diseased animals could be used to track NCC-affected individuals. Furthermore, even where available, serological tests for the diagnosis of T. solium NCC only have limited accuracy, particularly for single lesions and lesions located in the extraparenchymal space for which the tests often are false negative [6]. For this reason, most people with NCC in sub-Saharan Africa have unfortunately been diagnosed only in the context of scientific research projects and not in the general health care system.…”