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Exposure to Taenia solium through fecal contamination of food
Focal CNS lesions; seizures, headache
Brain imaging shows cysts; positive serologic tests
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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
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Cerebrospinal fluid examination may show
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
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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