CNS INFECTIONS-NEUROCYSTICERCOSIS

SUMMARY

1. Most common worldwide parasitic CNS infection caused by ingesting food/water contaminated with T. Solium (a tapeworm).

2. It forms cysts in the brain, which initially cause no syruptoms. But when the cyst walls break down several years later, it causes cerebral edema, with seizures as the first symptom.

3. In some, the cysticerci are located in the basilar subarachnoid space, where they induce an intense inflammatory reaction leading to hydrocephalus, vasculitis, and stroke as well as CN palsies.

4. MRI is the preferred imaging modality-when worms are viable, MRI shows multiple, non-enhancing hypodense lesions. As the worms die, they are surrounded by edema and flair.

5. Treatment: high-dose praziquantel or albendazole +/- corticosteroids.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].