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The Lancet. Neurology Dec 2014The infection of the nervous system by the cystic larvae of Taenia solium (neurocysticercosis) is a frequent cause of seizure disorders. Neurocysticercosis is endemic or... (Review)
Review
The infection of the nervous system by the cystic larvae of Taenia solium (neurocysticercosis) is a frequent cause of seizure disorders. Neurocysticercosis is endemic or presumed to be endemic in many low-income countries. The lifecycle of the worm and the clinical manifestations of neurocysticercosis are well established, and CT and MRI have substantially improved knowledge of the disease course. Improvements in immunodiagnosis have further advanced comprehension of the pathophysiology of this disease. This knowledge has led to individualised treatment approaches that account for the involvement of parenchymal or extraparenchymal spaces, the number and form of parasites, and the extent of degeneration and associated inflammation. Clinical investigations are focused on development of effective treatments and reduction of side-effects induced by treatment, such as seizures, hydrocephalus, infarcts, and neuroinjury.
Topics: Animals; Humans; Magnetic Resonance Imaging; Neurocysticercosis; Seizures; Swine; Taenia solium; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 25453460
DOI: 10.1016/S1474-4422(14)70094-8 -
Clinical Microbiology Reviews Jun 2020neurocysticercosis (NCC) is endemic in most of the world and contributes significantly to the burden of epilepsy and other neurological morbidity. Also present in... (Review)
Review
neurocysticercosis (NCC) is endemic in most of the world and contributes significantly to the burden of epilepsy and other neurological morbidity. Also present in developed countries because of immigration and travel, NCC is one of few diseases targeted for eradication. This paper reviews all aspects of its life cycle (taeniasis, porcine cysticercosis, human cysticercosis), with a focus on recent advances in its diagnosis, management, and control. Diagnosis of taeniasis is limited by poor availability of immunological or molecular assays. Diagnosis of NCC rests on neuroimaging findings, supported by serological assays. The treatment of NCC should be approached in the context of the particular type of infection (intra- or extraparenchymal; number, location, and stage of lesions) and has evolved toward combined symptomatic and antiparasitic management, with particular attention to modulating inflammation. Research on NCC and particularly the use of recently available genome data and animal models of infection should help to elucidate mechanisms of brain inflammation, damage, and epileptogenesis.
Topics: Animals; Antiparasitic Agents; Cysticercosis; Humans; Neurocysticercosis; Swine; Swine Diseases; Taenia solium; Taeniasis
PubMed: 32461308
DOI: 10.1128/CMR.00085-19 -
Neurology India 2021Post-infective hydrocephalus (PIH) arises as a complication of any CNS infection, and can be either communicating or noncommunicating. (Review)
Review
BACKGROUND
Post-infective hydrocephalus (PIH) arises as a complication of any CNS infection, and can be either communicating or noncommunicating.
OBJECTIVE
The aim of this article is to study the various causes of PIH and its pathophysiology and treatment.
MATERIAL AND METHODS
The literature was searched for articles describing the causes of PIH.
RESULTS
Common causes of PIH are CNS tuberculosis (TB), neurocysticercosis, and perinatal or neonatal infection. TBM is most likely to result in hydrocephalus out of all these manifestations of CNS TB, and hydrocephalus is more likely to occur early in the course, typically 4-6 weeks after the onset of TBM, and is more common among children as compared to adults. A trial of medical management (antitubercular therapy, steroids, and decongestants) can be given to patients with communicating hydrocephalus. Ventriculoperitoneal shunt is the most employed method of CSF diversion in these patients. Though traditionally considered contraindicated, many recent studies have found ETV to be a reasonable option in patients with PIH. HCP in patients with neurocysticercosis can be associated with intraventricular cysts and racemose cysts in the basal subarachnoid cisterns. Surgical intervention is required either for cyst removal or CSF diversion. Endoscopic approaches can be used to remove the intraventricular cysts, which takes care of the HCP. PIH in infants can result either from antenatal infections (TORCH infections) or postnatal infections such as meningitis.
CONCLUSIONS
Management of PIH can be challenging. Management has to be individualized.
Topics: Adult; Child; Female; Humans; Hydrocephalus; Infant; Infant, Newborn; Neurocysticercosis; Pregnancy; Subarachnoid Space; Ventriculoperitoneal Shunt; Ventriculostomy
PubMed: 35102983
DOI: 10.4103/0028-3886.332273 -
Acta Neurologica Taiwanica Mar 2014Cysticercosis is a parasitic infestation that can be seen in developing countries with poor sanitation. The infection at brain, called neurocysticercosis, is a serious... (Review)
Review
OBJECTIVE
Cysticercosis is a parasitic infestation that can be seen in developing countries with poor sanitation. The infection at brain, called neurocysticercosis, is a serious form. The neurocysticercosis can manifest neuropsychiatric presentations including dementia.
METHODS
In this short review, the author briefly summarizes on neurocysticercosis and dementia.
RESULTS
In clinical practice, neurocysticercosis can manifest several neuropsychiatric symptoms. Dementia is an important neuropsychiatric manifestation to be mentioned. Many dementia patients have neurocysticercosis as underlying etiology. The problem might be unrecognized by practitioner and this can result in a delayed diagnosed, hence, the concern of the practitioner is required.
CONCLUSION
Since the recovery after treatment of parasitic infection is very good, early diagnosis is a critical step determining success of patient management.
Topics: Dementia; Humans; Neurocysticercosis; Neuropsychiatry
PubMed: 24833208
DOI: No ID Found -
Clinical Infectious Diseases : An... Apr 2018
Diagnosis and Treatment of Neurocysticercosis: 2017 Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH).
Topics: American Medical Association; Communicable Diseases; Humans; Hygiene; Neurocysticercosis; Tropical Medicine; United States
PubMed: 29481580
DOI: 10.1093/cid/cix1084 -
Archives of Pathology & Laboratory... Oct 2010Neurocysticercosis is a significant public health issue within the United States. Although cysticercosis was once thought to have been eradicated in the United States,... (Review)
Review
Neurocysticercosis is a significant public health issue within the United States. Although cysticercosis was once thought to have been eradicated in the United States, the number of documented cases is rising and immigrants from endemic areas are at the highest risk for acquiring and developing this disease. The clinical presentation of neurocysticercosis is variable and vague neurologic symptoms or sudden unexplained death in individuals with risk factors may be the only available information warranting a consideration of neurocysticercosis. Radiologic and laboratory findings can help guide medical and surgical interventions, while histologic confirmation establishes a more definitive diagnosis. Encysted larvae can be found throughout the central nervous system and undergo progressive stages of decay. Degenerating vesicles elicit an inflammatory response, involving surrounding structures, and cause the major clinical symptomatology.
Topics: Diagnosis, Differential; Humans; Neoplasm Staging; Neurocysticercosis; Prognosis; United States
PubMed: 20923314
DOI: 10.5858/2008-0756-RS.1 -
Current Neurology and Neuroscience... Apr 2022Neurocysticercosis (NCC) has been well recognized as a leading cause of epilepsy. More recently, studies of other parasitic diseases such as cerebral malaria (CM)... (Review)
Review
PURPOSE OF THE REVIEW
Neurocysticercosis (NCC) has been well recognized as a leading cause of epilepsy. More recently, studies of other parasitic diseases such as cerebral malaria (CM) and onchocerciasis are yielding novel insights into the pathogenesis of parasite-associated epilepsy. We compare the clinical and electrophysiological findings in epilepsy associated with these highly prevalent parasites and discuss the mechanisms involved in epileptogenesis.
RECENT FINDINGS
Electrophysiological and imaging biomarkers continue to emerge, and individuals who are at-risk of developing parasite-associated epilepsies are being identified with greater reliability. While both Taenia solium and Plasmodium falciparum directly affect the brain parenchyma, Onchocerca volvulus is not known to invade the central nervous system. Thus, the causal association between O. volvulus and epilepsy remains controversial. Both NCC and CM have a well-defined acute phase when the parasites directly or indirectly invade the brain parenchyma and lead to local inflammatory changes. This is followed by a chronic phase marked by recurrent seizures. However, these stages of epileptogenic process have not been identified in the case of O. volvulus.
Topics: Epilepsy; Humans; Intestinal Volvulus; Neurocysticercosis; Parasitic Diseases; Reproducibility of Results
PubMed: 35332514
DOI: 10.1007/s11910-022-01187-6 -
World Neurosurgery Feb 2013Neurocysticercosis is the most common parasitosis of the central nervous system. Many forms, especially those inside the ventricles, carry a poor prognosis. Drug therapy... (Review)
Review
OBJECTIVE
Neurocysticercosis is the most common parasitosis of the central nervous system. Many forms, especially those inside the ventricles, carry a poor prognosis. Drug therapy is far from ideal.
METHODS
We propose and comment on the use of the endoscope to remove cysts, treat hydrocephalus, and to perform membrane fenestration as a way to simplify treatment.
RESULTS
Many patients, especially those with obstructive forms, benefit from the adjunctive use of neuroendoscopy.
CONCLUSIONS
Neurocysticercosis treatment remains challenging and multimodal. Endoscopes can be helpful in this setting.
Topics: Animals; Antiplatyhelmintic Agents; Cerebral Ventricles; Endoscopy; Humans; Neurocysticercosis; Neuroendoscopy; Neurosurgical Procedures; Praziquantel; Taenia solium; Ventriculoperitoneal Shunt
PubMed: 22381844
DOI: 10.1016/j.wneu.2012.02.019 -
Arquivos de Neuro-psiquiatria May 2022Neurocysticercosis (NCC) is a serious public health problem in several developing countries, including those in Latin America, Asia, and Africa. NCC is considered to be... (Review)
Review
BACKGROUND
Neurocysticercosis (NCC) is a serious public health problem in several developing countries, including those in Latin America, Asia, and Africa. NCC is considered to be the main cause of late-onset epilepsy in endemic areas.
OBJECTIVE
This review summarizes recent advances in diagnosis and therapy of NCC. Methods: Relevant articles and books were reviewed and used as a source of information for this review.
RESULTS
The diagnosis of NCC is based upon neuroimaging studies (MRI and computed tomography) and laboratory analysis of the cerebrospinal fluid (CSF). Praziquantel and albendazole are considered parasiticidal drugs against NCC, but there is an intense debate over the value and safety of these drugs.
CONCLUSION
Given the relative scarcity of clinical trials, more comparative interventional studies, especially randomized controlled trials in long-term clinical evolution, are required in order to clarify the controversy over the validity of parasitic therapy in patients with NCC.
Topics: Albendazole; Epilepsy; Humans; Magnetic Resonance Imaging; Neurocysticercosis; Praziquantel
PubMed: 35976305
DOI: 10.1590/0004-282X-ANP-2022-S115 -
Arquivos de Neuro-psiquiatria Jul 2020
Topics: Animals; Demyelinating Diseases; Disease Models, Animal; Neurocysticercosis
PubMed: 32725050
DOI: 10.1590/0004-282x20200034