Question
Neurocysticercosis
Answer
Neurocysticercosis is caused by the larval (cysticercus) stage of Taenia solium, developing when a human ingests infective eggs (not undercooked pork, which instead causes intestinal taeniasis) and the resulting oncospheres disseminate to encyst in the central nervous system.
Clinical significance: a major cause of acquired epilepsy/seizures in endemic regions; can also cause raised intracranial pressure/hydrocephalus (particularly with intraventricular/racemose cysts obstructing CSF flow) and focal neurological deficits; symptoms are often most acute when the cyst degenerates and dies, provoking an intense host inflammatory response.
Diagnosis: CT/MRI — showing characteristic cystic lesions, sometimes with a visible scolex (“hole-with-dot” appearance), at various stages of degeneration/calcification; serology (ELISA, EITB) supports diagnosis, particularly when imaging is equivocal.
Treatment: albendazole ± praziquantel combined with corticosteroids for viable parenchymal neurocysticercosis with seizures; antiepileptic drugs for seizure control; surgery for hydrocephalus/mass effect; calcified, inactive lesions generally require only symptomatic (antiepileptic) management.