Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 35-19: Invasive Cestode Infections + Key Features Download Section PDF Listen +++ ++ Exposure to Taenia solium through fecal contamination of food Focal CNS lesions; seizures, headache Brain imaging shows cysts; positive serologic tests + Clinical Findings Download Section PDF Listen +++ ++ Presenting symptoms include seizures, focal neurologic deficits, altered cognition, and psychiatric disease Symptoms develop more quickly with intraventricular cysts, with findings of hydrocephalus and meningeal irritation, including Severe headache Vomiting Papilledema Visual loss Neurocysticercosis Can cause intracerebral, subarachnoid, and spinal cord lesions and intraventricular cysts Single or multiple lesions may be present Lesions may persist for years before symptoms develop, generally due to local inflammation or ventricular obstruction Racemose cysticercosis A particularly aggressive form of the disease Involves proliferation of cysts at the base of the brain, leading to alterations of consciousness and death + Diagnosis Download Section PDF Listen +++ ++ Cerebrospinal fluid examination may show Lymphocytic or eosinophilic pleocytosis Decreased glucose Elevated protein Enzyme-linked immunosorbent assay (ELISA) and related immunoblot assays have excellent sensitivity and specificity, but sensitivity is lower with only single or calcified lesions Performing both CT and MRI is ideal CT is better for identification of calcification MRI is better for smaller and ventricular lesions + Treatment Download Section PDF Listen +++ ++ Benefits of cyst clearance must be weighed against potential harm of an inflammatory response to dying worms When treatment is deemed appropriate, standard therapy consists of albendazole (10–15 mg/kg/day orally for 8 days) or praziquantel (50 mg/kg/day orally for 15–30 days) Corticosteroids are usually administered concurrently, but dosing is not standardized Anticonvulsant therapy should be provided (if needed) and shunting performed (if required) for elevated intracranial pressure Surgical removal of cysts may be helpful for some difficult cases of neurocysticercosis and for symptomatic non-neurologic disease