Neurocysticercosis

Neurocysticercosis is a neurologic infection with the cestode parasite Taenia solium. T. solium is endemic worldwide where pigs are raised and have access to human feces, including much of Latin America, Sub-Saharan Africa, parts of Asia, and Oceania. Infection is acquired by ingesting microscopic ova shed by a tapeworm carrier. Clinical manifestations and optimal treatment vary by the location and stage of infection. Initial management should focus on the treatment of seizures and hydrocephalus. Cysticerci in the brain parenchyma usually present with seizures, which should be treated with antiseizure medications. Viable and degenerating cysticerci should be treated with corticosteroids and antiparasitic medications. Cysticerci in the ventricles should be removed if possible, often by neuroendoscopy. Subarachnoid neurocysticercosis often requires prolonged courses of antiinflammatory medications, antiparasitic drugs, and diversion for hydrocephalus.