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Cysticercosis: Recent advances in diagnosis and management of neurocysticercosis

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Abstract

Neurocysticercosis, caused by infection with the pork tapeworm Taenia solium, is increasingly recognized as a cause of neurologic disease worldwide. Because the clinical presentation is nonspecific, diagnosis has been difficult. Advances in imaging studies and serodiagnostic techniques are facilitating the diagnosis of neurocysticercosis and tapeworm carriers. Neurocysticercosis represents a spectrum of disease. Seizures are the main clinical manifestation in parenchymal neurocysticercosis. Recent studies emphasize that such seizures are the result of the host inflammatory response, even in patients who only have calcifications with no viable cysticerci. Controlled clinical trials have demonstrated that antiparasitic drugs can decrease the number of generalized seizures, although the benefit is small and confined to a subgroup of patients. Corticosteroids can also decrease seizure frequency. Case studies have demonstrated that endoscopic surgery appears to be the optimal approach to ventricular cysts. Recombinant vaccines are being developed and may prove important in disease control.

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Article 09 July 2018

Ricardo Santos de Oliveira, Dinark Conceição Viana, … José Francisco Manganelli Salomão

References and Recommended Reading

  1. White AC Jr: Neurocysticercosis: updates on epidemiology, pathogenesis, diagnosis, and management. Ann Rev Med 2000, 51:187–206.

    Article  PubMed  CAS  Google Scholar 

  2. Garcia HH, Gonzalez AE, Evans CA, et al.: Taenia solium cysticercosis. Lancet 2003, 362:547–556. A broad overview of cysticercosis not limited to the CNS.

    Article  PubMed  Google Scholar 

  3. Zoli A, Shey-Njila O, Assana E et al.: Regional status, epidemiology and impact of Taenia solium cysticercosis in Western and Central Africa. Acta Trop 2003, 87:35–42.

    PubMed  Google Scholar 

  4. Phiri IK, Ngowi H, Afonso S, et al.: The emergence of Taenia solium cysticercosis in Eastern and Southern Africa as a serious agricultural problem and public health risk. Acta Trop 2003, 87:13–23.

    PubMed  Google Scholar 

  5. Hira PR, Francis I, Abdella NA, et al.: Cysticercosis: imported and autochthonous infection in Kuwait. Trans R Soc Trop Med Hyg 2004, 98:233–239.

    Article  PubMed  Google Scholar 

  6. Townes JM, Hoffmann CJ, Kohn MA: Neurocysticercosis in Oregon, 1995–2000. Emerg Infect Dis 2004, 10:508–510.

    PubMed  Google Scholar 

  7. Ong S, Talan DA, Moran GJ, et al.: Neurocysticercosis in radiographically imaged seizure patients in U.S. emergency departments. Emerg Infect Dis 2002, 8:608–613.

    Article  PubMed  Google Scholar 

  8. Del Brutto OH, Wadia NH, Dumas M, et al.: Proposal of diagnostic criteria for human cysticercosis and neurocysticercosis. J Neurol Sci 1996, 142:1–6.

    Article  PubMed  Google Scholar 

  9. Del Brutto OH, Rajshekhar V, White AC Jr, et al.: Proposed diagnostic criteria for neurocysticercosis. Neurology 2001, 57:177–183. The most recent consensus criteria for the diagnosis of neurocysticercosis from the Neurocysticercosis Working Group.

    PubMed  Google Scholar 

  10. Garg RK: Diganostic criteria for neurocysticercosis: some modifications are needed for Indian patients. Neurol India 2004, 52:171–177.

    PubMed  Google Scholar 

  11. Jeri C, Gilman RH, Lescano AG, et al.: Species identification after treatment for human taeniasis. Lancet 2004, 363:949–950.

    Article  PubMed  Google Scholar 

  12. Gonzalez LM, Montero E, Morakote N, et al.: Differential diagnosis of Taenia saginata and Taenia saginata asiatica taeniasis through PCR. Diagn Microbiol Infect Dis 2004, 49:183–188.

    Article  PubMed  CAS  Google Scholar 

  13. Yamasaki H, Allan JC, Sato MO, et al.: DNA differential diagnosis of taeniasis and cysticercosis by multiplex PCR. J Clin Microbiol 2004, 42:548–553.

    Article  PubMed  CAS  Google Scholar 

  14. Wilkins PP, Allan JC, Verastegui M, et al.: Development of a serologic assay to detect Taenia solium taeniasis. Am J Trop Med Hyg 1999, 60:199–204.

    PubMed  CAS  Google Scholar 

  15. Levine MZ, Calderon JC, Wilkins PP, et al.: Characterization, cloning, and expression of two diagnostic antigens for Taenia solium tapeworm infection. J Parasitol 2004, 90:631–638.

    Article  PubMed  CAS  Google Scholar 

  16. Hancock K, Pattabhi S, Greene RM, et al.: Characterization and cloning of GP50, a Taenia solium antigen diagnostic for cysticercosis. Mol Biochem Parasitol 2004, 133:115–124.

    Article  PubMed  CAS  Google Scholar 

  17. Kojic EM, White AC Jr: A positive enzyme-linked immunoelectrotransfer blot assay result for a patient without evidence of cysticercosis. Clin Infect Dis 2003, 36:e7-e9.

    Article  PubMed  Google Scholar 

  18. Hancock K, Khan A, Williams FB, et al.: Characterization of the 8-kilodalton antigens of Taenia solium metacestodes and evaluation of their use in an enzyme-linked immunosorbent assay for serodiagnosis. J Clin Microbiol 2003, 41:2577–2586.

    Article  PubMed  CAS  Google Scholar 

  19. Fleury A, Hernandez M, Fragoso G, et al.: Detection of secreted cysticercal antigen: a useful tool in the diagnosis of inflammatory neurocysticercosis. Trans R Soc Trop Med Hyg 2003, 97:542–546.

    Article  PubMed  CAS  Google Scholar 

  20. Mishra AM, Gupta RK, Jaggi RS, et al.: Role of diffusion-weighted imaging and in vitro proton magnetic resonance spectroscopy in the differential diagnosis of ring-enhancing intracranial cystic mass lesions. J Comput Assist Tomogr 2004, 28:540–547.

    Article  PubMed  Google Scholar 

  21. Braga F, Rocha AJ, Gomes HR, et al.: Noninvasive MR cisternography with fluid-attenuated inversion recovery and 100% supplemental O(2) in the evaluation of neurocysticercosis. Am J Neuroradiol 2004, 25:295–297.

    PubMed  Google Scholar 

  22. Agarwal M, Chawla S, Husain N, et al.: Higher succinate than acetate levels differentiate cerebral degenerating cysticerci from anaerobic abscesses on in vivo proton MR spectroscopy. Neuroradiology 2004, 46:211–215.

    Article  PubMed  CAS  Google Scholar 

  23. Jayakumar PN, Srikanth SG, Chandrashekar HS, et al.: Pyruvate: an in vivo marker of cestodal infestation of the human brain on proton MR spectroscopy. J Magn Reson Imaging 2003, 18:675–680.

    Article  PubMed  Google Scholar 

  24. Chawla S, Gupta RK, Husain N, et al.: Prediction of viability of porcine neurocysticercosis with proton magnetic resonance spectroscopy: correlation with histopathology. Life Sci 2004, 74:1081–1092.

    Article  PubMed  CAS  Google Scholar 

  25. Garcia HH, Evans CA, Nash TE, et al.: Current consensus guidelines for treatment of neurocysticercosis. Clin Microbiol Rev 2002, 15:747–756. The most recent guidelines for the treatment of neurocysticercosis from the Neurocysticercosis Working Group.

    Article  PubMed  Google Scholar 

  26. Carpio A, Hauser WA: Prognosis for seizure recurrence in patients with newly diagnosed neurocysticercosis. Neurology 2002, 59:1730–1734.

    PubMed  Google Scholar 

  27. Garcia HH, Pretell EJ, Gilman RH, et al.: A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis. N Engl J Med 2004, 350:249–258. A large, randomized clinical trial examining the role of antiparasitic medications in seizure reduction in patients with neurocysticercosis.

    Article  PubMed  CAS  Google Scholar 

  28. Singh G, Kaushal S, Gupta M, Chander Chopra S: Cutaneous reactions in patients with solitary cysticercus granuloma on phenytoin sodium. J Neurol Neurosurg Psychiatry 2004, 75:331–333.

    PubMed  CAS  Google Scholar 

  29. Stringer JL, Marks LM, White AC Jr, Robinson P: Epileptogenic activity of granulomas associated with murine cysticercosis. Exp Neurol 2003, 183:532–536. This study documents the first animal model of seizures caused by neurocysticercosis to examine the contribution of the host immune response in epileptogenesis.

    Article  PubMed  Google Scholar 

  30. Rajshekhar V, Chandy MJ: Validation of diagnostic criteria for solitary cerebral cysticercus granuloma in patients presenting with seizures. Acta Neurol Scand 1997, 96:76–81.

    Article  PubMed  CAS  Google Scholar 

  31. Singhi P, Ray M, Singhi S, Khandelwal N: Clinical spectrum of 500 children with neurocysticercosis and response to albendazole therapy. J Child Neurol 2000, 15:207–213.

    PubMed  CAS  Google Scholar 

  32. Singhi P, Jain V, Khandelwal N: Corticosteroids versus albendazole for treatment of single small enhancing computed tomographic lesions in children with neurocysticercosis. J Child Neurol 2004, 19:323–327.

    PubMed  Google Scholar 

  33. Mall RK, Agarwal A, Garg RK, et al.: Short course of prednisolone in Indian patients with solitary cysticercus granuloma and new-onset seizures. Epilepsia 2003, 44:1397–1401.

    Article  PubMed  CAS  Google Scholar 

  34. Garg RK, Kar AM, Singh MK: Prednisolone-responsive headache in patients with solitary cysticercus granuloma and seizures. Headache 2004, 44:365–369.

    Article  PubMed  Google Scholar 

  35. Salinas R, Prasad K: Drugs for treating neurocysticercosis (tapeworm infection of the brain). Cochrane Database Syst Rev 2000, CD000215. A review of the medical treatment of neurocysticercosis.

  36. Nash TE, Del Brutto OH, Butman JA, et al.: Calcific neurocysticercosis and epileptogenesis. Neurology 2004, 62:1934–1938. A review of the pathogenesis and treatment of the calcific form of the disease.

    PubMed  CAS  Google Scholar 

  37. Garcia-Noval J, Moreno E, de Mata F, et al.: An epidemiological study of epilepsy and epileptic seizures in two rural Guatemalan communities. Ann Trop Med Parasitol 2001, 95:167–175.

    Article  PubMed  CAS  Google Scholar 

  38. Gupta RK, Kumar R, Chawla S, Pradhan S: Demonstration of scolex within calcified cysticercus cyst: its possible role in the pathogenesis of perilesional edema. Epilepsia 2002, 43:1502–1508.

    Article  PubMed  Google Scholar 

  39. Wichert-Ana L, Velasco TR, Terra-Bustamante VC, et al.: Surgical treatment for mesial temporal lobe epilepsy in the presence of massive calcified neurocysticercosis. Arch Neurol 2004, 61:1117–1119.

    Article  PubMed  Google Scholar 

  40. Torabi AM, Quiceno M, Mendelsohn DB, Powell CM: Multilevel intramedullary spinal neurocysticercosis with eosinophilic meningitis. Arch Neurol 2004, 61:770–772.

    Article  PubMed  Google Scholar 

  41. Psarros TG, Krumerman J, Coimbra C: Endoscopic management of supratentorial ventricular neurocysticercosis: case series and review of the literature. Minim Invasive Neurosurg 2003, 46:331–334. A case series examining the role of minimally invasive endoscopic management of ventricular neurocysticercosis.

    Article  PubMed  CAS  Google Scholar 

  42. Bergsneider M, Holly LT, Lee JH, et al.: Endoscopic management of cysticercal cysts within the lateral and third ventricles. J Neurosurg 2000, 92:14–23.

    Article  PubMed  CAS  Google Scholar 

  43. Bergsneider M, Nieto JH: Endoscopic management of intraventricular cysticercosis. In Taenia solium Cysticercosis: From Basic to Clinical Science. Edited by Singh G and Prabhakar S. Oxford: CABI Publishing; 2002:399–410. An overview of the pathogenesis and management of intraventricular disease.

    Google Scholar 

  44. Proano JV, Madrazo I, Avelar F, et al.: Medical treatment for neurocysticercosis characterized by giant subarachnoid cysts. N Engl J Med 2001, 345:879–885.

    Article  PubMed  CAS  Google Scholar 

  45. Marquez-Caraveo C, Gongora-Rivera F, Santos Zambrano J, et al.: Pre-treatment with corticosteroids and a single cycle of high dose albendazole for subarachnoidal cysticercosis. J Neurol Neurosurg Psychiatry 2004, 75:938–939.

    Article  PubMed  CAS  Google Scholar 

  46. Delobel P, Signate A, El Guedj M, et al.: Unusual form of neurocysticercosis associated with HIV infection. Eur J Neurol 2004, 11:55–58.

    Article  PubMed  CAS  Google Scholar 

  47. Gonzalez AE, Garcia HH, Gilman RH, et al.: Control of Taenia solium. Acta Trop 2003, 87:103–109.

    PubMed  Google Scholar 

  48. Lightowlers MW, Colebrook AL, Gauci CG, et al.: Vaccination against cestode parasites: anti-helminth vaccines that work and why. Vet Parasitol 2003, 115:83–123.

    Article  PubMed  CAS  Google Scholar 

  49. Flisser A, Gauci CG, Zoli A, et al.: Induction of protection against porcine cysticercosis by vaccination with recombinant oncosphere antigens. Infect Immun 2004, 72:5292–5297.

    Article  PubMed  CAS  Google Scholar 

  50. Guo YJ, Sun SH, Zhang Y, et al.: Protection of pigs against Taenia solium cysticercosis using recombinant antigen or in combination with DNA vaccine. Vaccine 2004, 22:3841–3847.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Baylor College of Medicine, One Baylor Plaza 535E, 77030, Houston, TX, USA

    A. Clinton White MD

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  1. Linda S. Yancey MD
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  2. Pedro J. Diaz-Marchan MD
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  3. A. Clinton White MD
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Yancey, L.S., Diaz-Marchan, P.J. & White, A.C. Cysticercosis: Recent advances in diagnosis and management of neurocysticercosis. Curr Infect Dis Rep 7, 39–47 (2005). https://doi.org/10.1007/s11908-005-0022-0

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