Neurocysticercosis is a parasitic infection, which affects brain, and caused by pork tapeworm taenia solum.
Generally Mature pork tapeworm lives in small intestines.
But sometimes human is infected by immature forms of tapeworm, which is called larval cyst.
(enclosed sacs containing the immature stage of a parasite).
The larval cysts can infect various parts of the body, causing a condition known as cysticercosis.
Larval cysts in the brain cause a form of cysticercosis called, neurocysticercosis, which can lead to seizures.
If left untreated, sometimes prognosis is fatal.
Neurocysticercosis, the most common helminthic infection of the nervous system, is a major cause of acquired epilepsy worldwide.
Neurocysticercosis is considered a Neglected Parasitic Infection, Which means infection, that occur primarily in settings of extreme poverty.
A person gets neurocysticercosis by swallowing microscopic eggs passed in the feces of a person who has an intestinal pork tapeworm.
For example, a person eats undercooked, infected pork and gets a tapeworm infection in the intestines.
She passes tapeworm eggs in her feces.
If she doesn’t wash her hands properly after using the bathroom, she may contaminate food or surfaces with feces containing these eggs.
These eggs may be swallowed by another person if they eat contaminated food.
Once inside the body, the eggs hatch and become larvae that find their way to the brain.
These larvae cause neurocysticercosis. It can affect any organ, but the most common sites of involvement are the central nervous system (subarachnoid space, ventricles, or spinal cord), eye, and muscle.
Infective embryos (hatched from the ingested eggs), reach the systemic circulation, after actively crossing the intestinal mucosa.
Some cysts are cleared by the liver.
Cysts lodge in capillaries (mostly in muscle and brain tissue),
where they develop into immature cysts and later into larval cysts, taking up to 3 months to reach this stage.
Cysts are protected from the host's immune response by the blood-brain barrier; no inflammatory response is noted as long as the cyst wall (rich in glycoproteins) remains intact.
When the parasite dies by natural processes or as a result of therapy, an inflammatory response with perilesional edema ensues, followed by calcification
Symptoms:
For instance, some patients with multiple cysts show no of inflammation or symptoms.
whereas others with fewer cysts present with severe edema andsymptoms.
Most common symptoms:
Seizures; Temporary confusion;
A staring spell;
Uncontrollable jerking movements of the arms and legs;
Loss of consciousness or awareness;
Headache;
Symptoms may be delayed for several years or may remain subclinical,
Most symptomatic patients are 15–40 years ol.
Seizures as a result of perilesional inflammation in degenerating cysts,
Patients with neurocysticercosis of the fourth ventricle may develop so-called, Bruns syndrome. which is characterized by headache, papilledema, and even unconsciousness, with rapid recovery triggered by rotatory movements of the head.
Neurocysticercosis is a preventable disease. Good hand washing practices and treating people infected with intestinal tapeworms could drastically reduce the number of new infections.
Treatment:
Cysticidal agents: ( albendazole and praziquantel).
Antiepileptic drugs in case of epileptic symtoms, and corticosteroids and other immunosuppressive or anti-inflammatory agents used to control the potentially harmful host inflammatory response.
Sometimes surgical intervention is needed.
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