Systematic Review and Meta-Analysis of Management Strategies and Outcomes in Adult Spinal Neurocysticercosis

Barrie, Umaru; Badejo, Olatunde; Aoun, Salah G.; Adeyemo, Emmanuel; Moler, Nicole; Christian, Zachary; Caruso, James P.; Ahmadieh, Tarek Y. El; Ban, Vin Shen; MacAllister, Matthew; Reyes, Valery Peinado; Hall, Kristen; Whitworth, Louis A.; Bagley, Carlos A.

doi:10.1016/j.wneu.2020.03.093

Cited by 8 publications

(7 citation statements)

References 60 publications

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“…A total of 24 lesions were found to be intramedullary, and 51 patients were diagnosed with primary spinal cysticercosis. However, in this systematic review, the authors did not summarize the radiological features of spinal cysticercosis [ 31 ]. Our study expanded the spectrum of MRI manifestations, and more subtle characteristics should be highlighted.…”

Section: Discussionmentioning

confidence: 99%

Spinal cysticercosis: a rare cause of myelopathy

Yang

et al. 2022

BMC Neurol

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Background Neurocysticercosis is a neuroinfectious disease caused by the larval stage of the tapeworm Taenia solium. Isolated spinal cysticercosis is rare, with limited cases having been reported in the literature. This entity poses great diagnostic and therapeutic challenges. Methods This retrospective study included seven patients pathologically diagnosed with spinal cysticercosis. The clinical manifestations, radiological features on magnetic resonance imaging (MRI), treatment, and outcomes were analyzed. Results This case series consisted of four male and three female patients, with an average age of 34.9 ± 10.9 years. Clinically, six patients manifested with localization-related myelopathy. There were four solid lesions, one cystic-solid lesion, and three cystic lesions. The solid and cystic-solid lesions showed characteristic MRI features: 1) within the lesion, there was a mural nodule with isointensity on T1WI and iso- to hyperintensity on T2WI; 2) the signals at the periphery of the mural nodule were variable, ranging from hypointense to hyperintense on T2WI; and 3) ring-like or cyst wall enhancement could be present, and dot-like enhancement could be noted in the mural nodule. Complete resection of the responsible lesion was achieved in all patients, and oral albendazole was administered in a patient with one more suspected homologous lesion. After a mean follow-up period of 56.7 ± 35.1 months, the patient’s symptoms mostly regressed. Conclusion Spinal cysticercosis is an extremely rare cause of myelopathy. Characteristic MRI features can facilitate preoperative diagnosis. Clinicians should be aware of this entity, and it should be included in the differential diagnosis of myelopathy.

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Section: Discussionmentioning

confidence: 99%

Spinal cysticercosis: a rare cause of myelopathy

Yang

et al. 2022

BMC Neurol

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“…With rarer spinal cord involvement, subacute or chronic myelopathy develops. 98 MRI is the preferred imaging modality for cysticercosis of the spine. 97 Leptomeningeal cysts are seen on MRI as cystic lesions or areas of arachnoiditis, and intramedullary cysticerci are rounded cysts.…”

Section: Neurocysticercosismentioning

confidence: 99%

“…The most common clinical presentations of spinal neurocysticercosis are focal motor deficits, radicular pain, sensory deficits from spinal subarachnoid disease. With rarer spinal cord involvement, subacute or chronic myelopathy develops 98 . MRI is the preferred imaging modality for cysticercosis of the spine 97 .…”

Section: Parasitic Myelopathiesmentioning

confidence: 99%

Infectious Myelopathies

Fletcher,

Bhattacharyya

2024

CONTINUUM: Lifelong Learning in Neurology

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Objective Infectious myelopathy of any stage and etiology carries the potential for significant morbidity and mortality. This article details the clinical presentation, risk factors, and key diagnostic components of infectious myelopathies with the goal of improving the recognition of these disorders and guiding subsequent management. Latest Developments Despite our era of advanced multimodal imaging and laboratory diagnostic technology, a causative organism often remains unidentified in suspected infectious and parainfectious myelopathy cases. To improve diagnostic capability, newer technologies such as metagenomics are being harnessed to develop diagnostic assays with a greater breadth of data from each specimen and improvements in infection identification. Conventional assays have been optimized for improved sensitivity and specificity. Essential Points Prompt recognition and treatment of infectious myelopathy decreases morbidity and mortality. The key diagnostic tools include serologies, CSF analysis, and imaging; however clinical presentation, epidemiologic risk factors, and history of recent illness are all vital to making the proper diagnosis because current laboratory and imaging modalities are often inconclusive. The cornerstone of recommended treatment is targeted antimicrobials with appropriate immune modulation, surgical intervention, supportive care, and interdisciplinary involvement, all of which further improve outcomes for patients with infectious myelopathy.

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“…This approach includes the use of antiseizure medications, anti-inflammatory drugs, corticosteroids, corticosteroid-sparing agents and etanercept, alone or in combination [ 57 , 58 , 59 , 60 ]. Surgical procedures, such as cysts’ resection, ventricular shunt placements, and decompressive craniotomies, are still needed in some cases [ 61 , 62 , 63 ].…”

Section: Treatmentmentioning

confidence: 99%

Human Neurocysticercosis: An Overview

Brutto

2022

Pathogens

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Human cysticercosis is caused by ingestion of T. solium eggs from taenia carriers. Neurocysticercosis (NCC), defined as the infection of the CNS and the meninges by the larval stage of Taenia solium, is the most common helminthic infection of the CNS worldwide. Parasites may lodge in brain parenchyma, subarachnoid space, ventricular system, or spinal cord, causing pathological changes that account for the pleomorphism of this disease. Seizures/epilepsy are the most common clinical manifestation, but other patients present with headache, focal deficits, intracranial hypertension, or cognitive decline. Accurate diagnosis of NCC is possible after interpretation of clinical data together with findings of neuroimaging studies and results of immunological tests. However, neuroimaging studies are fundamental for diagnosis because immunological test and clinical manifestations only provide circumstantial evidence of NCC. The introduction of cysticidal drugs changed the prognosis of most NCC patients. These drugs have been shown to reduce the burden of infection and to improve the clinical course of the disease in many patients. Efforts should be directed to eradicate the disease through the implementation of control programs against all the steps in the life cycle of T. solium, including carriers of the adult tapeworm, infected pigs, and eggs in the environment.

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Systematic Review and Meta-Analysis of Management Strategies and Outcomes in Adult Spinal Neurocysticercosis

Cited by 8 publications

References 60 publications

Spinal cysticercosis: a rare cause of myelopathy

Spinal cysticercosis: a rare cause of myelopathy

Infectious Myelopathies

Human Neurocysticercosis: An Overview

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