Neurocysticercosis is also called cerebral cysticercosis; it is a severe form of cysticercosis that affects the brain when the larvae of Taenia solium forms cysts in the brain. It gives rise to seizures and many other CNS manifestations.

Neurocysticercosis Epidemiology

Neurocysticercosis is very common in Latin America and it is the commonest cause of seizures in this region of the world.

Neurocysticercosis Pathogenesis

Neurocysticercosis occurs when the larvae (known as cysticerci) of Taenia solium (pork tapeworm) gain entry into the brain and from cyst. The cysticerci can become very large in the brain and a form space-occupying lesion that gives rise to the symptoms seen in Neurocysticercosis especially seizures. In the Central nervous system (CNS), the metacestodes (or the cysticerci) are usually found in the cerebrum, particularly in the ventricles and the subarachnoidal space but are rarely in the spinal cord. Living cysticerci do not cause inflammation, but when they die they can release substances that provoke an inflammatory response and cause this type of Cysticercosis. Eventually, the cysticerci calcify.

There are usually about 7 to 10 cysts in the brain and these cause seizures, focal neurological deficits or obstructive hydrocephalus. The cysticerci in the brain normally grow slowly and may take a period of 5 to 0 years before dying and releasing chemicals that trigger inflammation and enhanced the symptoms often observed in the Neurocysticercosis.

Cysticercus cellulosae seen in the brain

Radiological imaging and Stages

Neurocysticercosis lesions can be seen using MRI or CT Scan. The lesions have four distinct phases that can be seen on contrast CT scan and these phases include vesicular phase, colloidal phase, granular phase and nodular phase.

Lesions of the Vesicular phase are cyst-like in form and minimally enhance with contrast; the cysticerci die in the colloidal phase and release inflammatory substances that cause edema in its surrounding and shows slight contrast enhancement. The granular phase produces a ring-enhancing lesion while the nodular phase involves a calcified lesion with no contrast enhancement.

Neurocysticercosis is usually cause by the presence of cysticercus cellulosae as seen in this brain CT Scan picture

Neurocysticercosis Symptoms and Signs

1. Vomiting as a result of raised intracranial pressure
2. Headache
3. Meningitis
4. Focal neurological deficits
5. Seizures very common
6. Hydrocephalus may occur
7. Personality change

Neurocysticercosis Diagnosis

1. It is diagnosed by CT scan
2. Magnetic Resonance Imaging (MRI)
3. The CSF shows lymphocytic or eosinophilic pleocytosis (different lymphocytes and eosinophils are seen)
4. Biopsy of the brain can also be done

Neurocysticercosis Treatment

Neurocysticercosis is treated using Praziquantel and corticosteroids for concomitant cerebral inflammation steroids when calcifications have not formed but can only be surgically removed once calcifications have occur; anticonvulsant drugs are given to prevent convulsions.

Neurocysticercosis Prevention

1. Proper washing of vegetables and fruits before eating
2. Avoid use of human manure in farms
3. Practice good hygiene by washing of hands before eating
4. Treatment of infected individuals to prevent autoinfection