Evidence-based guideline: Treatment of parenchymal neurocysticercosis [RETIRED]

Abstract

Objective: To review the evidence base for different treatment strategies in intraparenchymal neurocysticercosis in adults and children.

Parenchymal neurocysticercosis

“…Its prevalence is higher in rural areas in those countries in which pigs are raised in free-roaming fields where human fecal contamination of soil is a common practice [1,2]. T. solium causes two distinct forms of parasitic infection in humans, known as taeniasis and cysticercosis [2][3][4]. Taeniasis is a localized human intestinal infection, transmitted by eating raw or undercooked pork muscle tissue containing T. solium cysts.…”

“…Then the embryos hatch in the intestine into the larvae, which penetrate the bowel wall and finally migrate to different parts of the body, becoming encysted in end organs. Cysticercosis can involve the nervous system and the extra-neural system (subcutaneous tissues, striated muscle, liver, or lung) [1,3].…”

“…Extra-parenchymal forms of NCC affect the CSF space, eyes, and spinal cord [1,4,5]. In endemic countries, parenchymal NCC is regarded as the most common preventable cause of acquired seizure [3]. It is recognized by the World Health Organization as one of the major neglected tropical diseases [2].…”

“…Clinical manifestations of NCC depend on the number, location, size, stages of cysticercal cysts in the brain, and the degree of the host immune response [1,3,5]. Parenchymal NCC is the second most common form of NCC after subarachnoid NCC.…”

“…When the host immune system induces inflammatory response around the cysts, headaches and seizures are the most commonly presented features, followed by focal neurologic deficits or altered mental status. Fever is typically absent [3,5]. Both the CT scan and MR imaging have increased the possibility of diagnostic accuracy for NCC.…”