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Neurocysticercosis
Last reviewed: 23.04.2024
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[Causes of the neurocysticercosis
After a person consumes contaminated food, the larvae migrate throughout the body, including the brain and spinal cord, the liquor-conduction pathways, and form cysts.
The size of the cysts in the parenchyma of the brain is usually not more than 1 cm, while the size of the cysts freely floating in the cerebrospinal fluid can exceed 5 cm.
Symptoms of the neurocysticercosis
Clinical symptoms of neurocysticercosis are minimal until the larvae die within the cysts, when local inflammation, gliosis, and edema develop, manifested by epileptiform seizures (the most common symptom), mental disorders and personality changes or focal neurologic symptoms. In the case of occlusion of the ventricles of the brain with free-floating cysticercas, obstructive hydrocephalus develops. With the rupture of cysts and the entry of their contents into the cerebrospinal fluid, subacute eosinophilic meningitis develops. Mortality with neurocysticercosis is up to 50%.
Diagnostics of the neurocysticercosis
The basis for suspecting a patient of neurocysticercosis is information about visits to endemic areas or developing countries, the presence of eosinophilic meningitis or unexplained convulsive seizures, focal neurological disorders and mental disorders. Suspicion is confirmed when multiple calcified pathological cysts are found on CG or MRI, the use of contrast allows for a clearer picture of pathological foci. The diagnosis is finally verified by serological examination of serum and CSF, sometimes the contents of cysts.
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Treatment of the neurocysticercosis
Albendazole (7.5 mg / kg orally every 12 hours for 8-30 days, the maximum daily dose of 800 mg) is the drug of choice. Alternatively, praziquantel can be used from 20 to 33 mg / kg orally 3 times / day for 30 days.
Dexamethasone 8 mg 1 time / sug orally or intravenously for the first 2-4 days will help reduce the intensity of acute inflammatory response to the death of larvae. For some time, anticonvulsant drugs may be in demand. According to the indications, surgical removal of cysts and the installation of a ventricular shunt are performed.