Neurocysticercosis
(cysticercosis)
Krizia del Rosario
April 12, 2012
http://www.human-healths.com/taenia-solium/taenia-solium.php
Caused by larval cysts (cysticerci) of
the pork tapeworm Taenia solium
http://www.human-healths.com/taeniasolium/taenia-solium.php
Sciutto et al. Microbes and Infection 2000. 2: 1875-1890
http://www.sciencedirect.com/science/article/pii/S1286457900013368
Endemic in Mexico, Central and
South America, and parts of Africa,
Asia and India
http://www.astrium.com/Cysticercose.html
Spread via the oral-fecal route
Spread by T. solium eggs via food, water or
surfaces contaminated with infected feces.
 Less commonly spread via autoinfection

Life Cycle of Taenia solium
http://www.cdc.gov/parasites/cysticercosis/biology.html
The cyst undergoes 4 distinct stages
DeGiorgio et al. Epilepsy Currents 2004, 4: 107-111
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/
Stage 1:Vesicular cyst
DeGiorgio et al. Epilepsy Currents 2004, 4: 107-111
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/
Stage 2: Colloidal cyst
DeGiorgio et al. Epilepsy Currents 2004, 4: 107-111
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/
Stage 3: Nodular cyst
DeGiorgio et al. Epilepsy Currents 2004, 4: 107-111
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/
Stage 4: Calcified cyst
DeGiorgio et al. Epilepsy Currents 2004, 4: 107-111
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/
Seizures occur in 70-90% of
symptomatic patients

Severe complications:
◦
◦
◦
◦
Intracranial hypertension
Hydrocephalus
Chronic meningitis
Cranial nerve abnormalities
Serological testing, CT scans and
MRI scans are used to detect
neurocysticercosis
Source:
http://reference.medscape.com/features/slid
eshow/neurocysticercosis
How do we treat this disease?
Antihelminthic medications
 Co-administration of anti-inflammatories
 Anticonvulsant therapy to manage
seizures
 Surgery

Co-administration of albendazole
and dexamethasone is the first-line
treatment

Albendazole

Praziquantel
Prevention is essential to decreasing
prevalence in developing countries



Strict meat inspection regulations
Sewage treatment and disposal
Health education
Is it possible to break the life cycle?
http://www.cdc.gov/parasites/cysticercosis/biology.html
YES!
http://www.cdc.gov/parasites/cysticercosis/biology.html
YES!
http://www.cdc.gov/parasites/cysticercosis/biology.html
YES!
http://www.cdc.gov/parasites/cysticercosis/biology.html
Is there a vaccine?
The S3Pvac vaccine has been developed
against porcine cysticercosis to break the
transmission cycle.
 Effective, but not yet widely used.

Future Goals

By 2015:
◦ Strategy for control
and elimination T. solium

Accelerating Work
to Overcome the
Global Impact of
Neglected Tropical
Diseases
By 2020:
◦ Interventions scaled up
in Africa, Asia and Latin
America for T. solium
control and elimination
References
1. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001651/
2. http://www.cdc.gov/parasites/cysticercosis/
3. http://www.who.int/zoonoses/diseases/taeniasis/en/
4. http://www.aafp.org/afp/2007/0701/p91.html
5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/pdf/epc_43008.pdf
6. http://www.galvmed.org/news-resources/content/global-collaboration-produce-vaccine-helpprevent-epilepsy-developing-world
7. http://ac.els-cdn.com/S0264410X12001934/1-s2.0-S0264410X12001934main.pdf?_tid=06eeb4b047aadd2d242c65ea01540446&acdnat=1333505466_80197ca318440
3236770733b6b663675
8. http://www.sciencedirect.com/science/article/pii/S0264410X06003379
9. http://www.springerlink.com/content/675385504w070160/fulltext.pdf
10. http://whqlibdoc.who.int/hq/2012/WHO_HTM_NTD_2012.1_eng.pdf
11. http://www.ajtmh.org/content/72/1/3/F2.expansion?ck=nck
12. http://neurosurgery.ucla.edu/body.cfm?id=186
13. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/
14. http://www.sciencedirect.com/science/article/pii/S1286457900013368
15. http://www.ispub.com/journal/the-internet-journal-of-neurology/volume-7-number1/epilepsy-neurocysticercosis-and-poverty-at-mphumaze-and-marhambeni-locations-insouth-africa.html
16. http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0011287
17. http://emedicine.medscape.com/article/1168784-overview