From the Guidelines
Neurocysticercosis has a significant incidence worldwide, with estimates suggesting over 2000 cases per year in the United States alone, resulting in substantial morbidity, mortality, and economic burden 1. The incidence of neurocysticercosis varies globally, with the highest rates found in developing countries across Latin America, sub-Saharan Africa, and parts of Asia.
- In endemic regions, neurocysticercosis is linked to approximately 29% of cases of seizures 1.
- The disease is caused by the larval stage of the pork tapeworm Taenia solium infecting the central nervous system, typically through ingestion of food or water contaminated with eggs from human feces.
- Risk factors include poor sanitation, inadequate hygiene practices, and consumption of undercooked pork in areas where pigs have access to human feces.
- The incidence has been declining in some regions due to improved sanitation, pig management practices, and public health interventions, but it remains a significant cause of acquired epilepsy in many parts of the world.
- Hospital charges associated with neurocysticercosis in the United States are nearly $100 million per year 1, highlighting the need for effective prevention and treatment strategies to reduce the burden of this disease.
From the Research
Incidence Data for Neurocysticercosis
- Neurocysticercosis is a major contributor to the burden of seizure disorders and epilepsy in most of the world 2
- It is an important cause of neurological disease worldwide, including imported cases in nonendemic countries 3
- The disease is endemic in most of Latin America, Sub-Saharan Africa, Southeast Asia, India, and China 4
Epidemiology
- Neurocysticercosis causes a substantial burden of seizure disorders worldwide 5
- The purpose of a recent review was to update information on diagnosis, management, and prevention of neurocysticercosis 3
- Field studies are demonstrating the feasibility of eradication using a combination of mass chemotherapy for human tapeworms and vaccination/treatment of porcine cysticercosis 3
Clinical Presentations
- Neurocysticercosis encompasses a variety of clinical presentations, depending on number, location, size, evolutionary stage of lesions, and the inflammatory response of the host 2
- Late-onset seizures, headache, and intracranial hypertension are the most frequent manifestations 2
- Common symptoms include seizures, headache, and motor weakness/paresis 6
Treatment and Management
- Diagnosis and therapy depend on the type of neurocysticercosis, considering its location and stage of the lesions 2
- Medical therapy for neurocysticercosis should be oriented to obtain appropriate symptom control and then use of antiparasitic agents considered 2
- Antiparasitic treatment is of benefit in most cases of viable and degenerating neurocysticercosis 2
- Combination of albendazole plus praziquantel increases the parasiticidal effect in patients with multiple brain cysticercosis cysts without increased side-effects 5