Go Back Brain/18. More than one of above/Inflammation/18.2 Racemose cysticercosis/ Go to Index

ÿþCysticercosis

Cysticercosis affects 50 million people worldwide.

Endemic areas: Mexico and Latin America, sub-Saharan Africa, India, and East Asia.

NCC is a leading cause of adult-onset seizures worldwide.

An estimated 1000 new cases are diagnosed per year in the United States.

In SW, with large population of immigrants, NCC may account for at least 10% of seizures seen in some emergency departments and more than 2% of neurological or neurosurgical admissions.

Diagnosis of NCC should be considered in any patient from an endemic area presenting with new-onset seizures.

Cysticercosis

Systemic disorder .

Caused by dissemination of the larval form of the pork tapeworm, Taenia solium.

Morbidity:

seizures, strokes, or hydrocephalus.

difficult long-term treatment with anticonvulsants, steroids, or shunting.

Mortality:

rare - generally limited to cases complicated by encephalitis, increased intracranial pressure (ICP) secondary to edema, and/or hydrocephalus and strokes.

Cysticercosis

Acquired from ingestion of insufficiently cooked pork containing encysted larvae.

Larvae develop into adult tapeworms and release oncospheres (active embryos).

Oncospheres burrow through GI tractàð reach the bloodstream and are carried to the CNS.

Cysticercosis

Neurologic sequela:

Seizures, most common (30-92%)

Hydrocephalus

Psychological disturbance

Paresthesias, paralysis

Cysticercosis

Cysticerci vary in size from pinpoint to 6 cm.

Variable in location:

Parenchyma

Subarachnoid space

Ventricles (4th ventricle most common).

Cysticercosis

Stage I: Vesicular stage

-Live larvae with cyst.

-Minimal to no edema with cyst surrounded by thin capsule.

Stage II: Colloidal Vesicular

-Larvae death àð can elicit acute inflammatory reaction.

-In some complicated cases may see strong inflammatory response with encephalitis.

Cysticercosis

Stage III: Granular Nodular Stage

-Cyst decreases in size.

-May begin to see early calcification

-May see enhancement as larvae die.

Stage IV: Nodular Calcified Stage

-Small focal calcifications representing dead larvae.

Racemose Cysticercosis