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What is Neurocysticercosis?

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  • Written By: Di L.
  • Edited By: Bronwyn Harris
  • Last Modified Date: 25 September 2016
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Neurocysticercosis is a disease in which tapeworm larvae of the Taenia genus invade the tissues of the brain and central nervous system to form cysts. These cysts, when present in non-neural tissue, are known as cysticerci. They may form in many soft tissues of the body, including skin, muscles, and the heart, but neurocysticercosis is the most dangerous form of infection.

The encysted larvae may exist in a dormant state in the brain for years without provoking an attack from the immune system. It is only when there are a large number of cysts, or when a cyst dies and releases its contents, that the body mounts an immune response against the invading pathogen. Neurocysticercosis was mainly a disease of the developing world, but is becoming more frequently observed in the United States. It is usually detected by magnetic resonance imaging (MRI) during hospital visits for headache or seizure.

Humans come in contact with the tapeworm eggs by ingesting food contaminated with human feces, which contain the eggs. Since the adult form of Taenia solium, the pork tapeworm, can only exist in humans, only human fecal material will contain eggs. Taenia sanginata, the beef tapeworm, rarely causes neurocysticercosis. The protective cover of the eggs is dissolved by stomach acid and the invasive larvae enter the bloodstream. From there, they can travel to a number of tissues.

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Cysticercosis can also form in pigs when they ingest food contaminated by tapeworm eggs. These will hatch and form cysts in the pig’s body. If proper care is not taken when processing or cooking pork products for human consumption, the larvae can enter the small intestine through the normal digestive process, hook itself onto the intestinal wall, and develop into an adult tapeworm. In people who carry an adult tapeworm, autoinfection is possible via retroperistalsis, when the contents of the digestive tract move in the opposite direction. This usually occurs during vomiting when the adult tapeworm segments containing eggs are pushed back into the stomach and the eggs hatch via the normal infection route.

Neurocysticercosis can be treated in various ways, according to the amount, condition, and location of cysts present in the nervous system. A single cyst in the eye may require surgical treatment to prevent blindness caused by the pressure of the cyst against the optic nerve; a cyst in the spine may lead to paralysis; cysticerci in the brain can lead to epileptic seizures, depending on their location. A viable larval cyst will elicit only a very weak immune response, but a deteriorating cyst will release its contents into the host environment, which will cause an attack by the immune system.

Whether or not a patient should be treated is a controversial topic. Some researchers believe that using anti-parasitic drugs that kill the larvae will only aggravate the patient’s symptoms, as it is the dead cyst that provokes an immune response. When treatment is prescribed, it usually involves a combination of anti-parasitic and anti-inflammatory drugs. In many cases, patients with a small number of cysts will not be treated with medication. Surgical removal of cysts is accompanied by anti-inflammatory drugs. Patients whose seizures are caused by a dead cyst are usually not treated, but the symptoms should diminish as the larvae are gradually removed by the body with time.

Neurocysticercosis is present in 70% - 90% of patients presenting with acutely symptomatic seizures. Epileptic seizures usually begin when the cyst is still viable or just beginning to degenerate. However, chronic seizures are mostly caused by dead cysts. The first epileptic episode usually occurs when the cyst is beginning to degenerate by releasing its contents into the brain. The location of the cyst in the brain and the patient’s immune response are the factors that set off the first seizure. Neurocysticercosis can be prevented by practicing proper hygiene and cooking or freezing meats thoroughly. Beware of any food from locations where human waste may be used as fertilizer.

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anon285681
Post 5

My name is Pinki and I was diagnosed with neurocysticercosis in 2004. I was on medication for five years, then the doc stopped my medication since I was normal, but he told me to do regular aerobics. Then I got married and I stopped doing exercise. Now in 2012 I have had a relapse. What should I do now?

anon169222
Post 4

my husband age 30 is suffering from neurocysticercosis. the first symptoms and the diagnosis was done in 2005 after which he was on medication. in 2008 he was declared fit as his reports were clear and there was no cyst formation whatsoever. In 2009 march he had a relapse and he was on medication again. In dec 2009 in between the change in the course of medication he had four seizures in 10 days and was admitted to the hospital. he has been on medication ever since.

he gets his ct scans done regularly and his medication involves Eptoin 300 MG and Torleva at night. could you please tell me how long will he have to take these medicines? will it get cured completely? What are the side effects of the above mentioned medicines? Please help!

anon57706
Post 3

I'm Manohar. I am suffering from neurocysticercosis. I had the first indicating seizure in 1998. Scan report indicated a cyst in the right part of the brain. I was on Albendazol then and finally the MRI revealed that there was no cyst anymore.

Then I was advised to take a course of Tegretol CR200 for the next five years. And in 2003 when I stopped the medication I had a seizure again. So it was a relapse. Since then I've been on Zeptol CR 200.

Six months ago, the EEG report reported normal electrical activity in my brain and my doctor has started reducing my dosage so that the medicine could be stopped once and for all. I'm worried about the relapse again.

Please tell me what are the chances of relapse, and how can it be avoided? Eagerly awaiting a reply. Thanks a ton in advance.

anon35832
Post 2

Hi, I am chitra. My would be husband is suffering from Neurocysticercosis in his brain from past one year. he is under treatment but a few months back he had a severe attack and admitted to the hospital. now his treatment is going on. he is taking medicine but he is feeling a numbness or cramps in his right leg which are staying for couple of minutes. please help to to know about this disease and how far curable this is and how far he have to take medicine. please please help me. reply as soon as possible.

anon31731
Post 1

This is Anant. My brother is infected from this disease since last 8 months back. His current age is 26 years. Now he is taking treatment from Neurosurgeon for last 5 months, he will clear/healthy or are their some risks? I am very worried about it. Please i am waiting...

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