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Neurocysticercosis
Last reviewed: 04.07.2025
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[ Causes neurocysticercosis
After a person consumes contaminated food, the larvae migrate throughout the body, including the brain, spinal cord, and cerebrospinal fluid pathways, and form cysts.
The size of cysts in the brain parenchyma is usually no more than 1 cm, while the size of cysts freely floating in the cerebrospinal fluid can exceed 5 cm.
Symptoms neurocysticercosis
Clinical symptoms of neurocysticercosis are minimal until the larvae die inside the cysts, when local inflammation, gliosis, and edema develop, manifested by epileptiform seizures (the most characteristic symptom), mental disorders, and personality changes or focal neurological symptoms. In the case of occlusion of the cerebral ventricles by free-floating cysticerci, obstructive hydrocephalus develops. When cysts rupture and their contents enter the cerebrospinal fluid, subacute eosinophilic meningitis develops. Mortality in neurocysticercosis is up to 50%.
Diagnostics neurocysticercosis
The basis for suspecting neurocysticercosis in a patient is information about visiting endemic areas or developing countries, the presence of eosinophilic meningitis or unexplained seizures, focal neurological disorders and mental disorders. Suspicion is confirmed by detection of multiple calcified pathological cysts on CG or MRI; the use of contrast allows obtaining a clearer image of pathological foci. The diagnosis is finally verified by serological testing of blood serum and CSF, sometimes the contents of cysts.
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Treatment neurocysticercosis
Albendazole (7.5 mg/kg PO every 12 hours for 8 to 30 days; maximum daily dose 800 mg) is the drug of choice. Alternatively, praziquantel 20 to 33 mg/kg PO 3 times daily for 30 days may be used.
Dexamethasone 8 mg once a day orally or intravenously during the first 2-4 days will help reduce the intensity of the acute inflammatory response to the death of larvae. Anticonvulsants may be required for some time. If indicated, surgical removal of cysts and installation of a ventricular shunt are performed.