Neurocysticercosis (cysticercosis) Krizia del Rosario April 12,

Caused by larval cysts (cysticerci) of the pork tapeworm Taenia solium solium/taenia-solium.php Sciutto et al. Microbes and Infection :

Endemic in Mexico, Central and South America, and parts of Africa, Asia and India

Spread via the oral-fecal route Spread by T. solium eggs via food, water or surfaces contaminated with infected feces. Less commonly spread via autoinfection

Life Cycle of Taenia solium

The cyst undergoes 4 distinct stages DeGiorgio et al. Epilepsy Currents 2004, 4:

Stage 1: Vesicular cyst DeGiorgio et al. Epilepsy Currents 2004, 4:

Stage 2: Colloidal cyst DeGiorgio et al. Epilepsy Currents 2004, 4:

Stage 3: Nodular cyst DeGiorgio et al. Epilepsy Currents 2004, 4:

Stage 4: Calcified cyst DeGiorgio et al. Epilepsy Currents 2004, 4:

Seizures occur in 70-90% of symptomatic patients Severe complications: ◦ Intracranial hypertension ◦ Hydrocephalus ◦ Chronic meningitis ◦ Cranial nerve abnormalities

Serological testing, CT scans and MRI scans are used to detect neurocysticercosis Source: eshow/neurocysticercosis

How do we treat this disease? Antihelminthic medications Co-administration of anti-inflammatories Anticonvulsant therapy to manage seizures Surgery

Co-administration of albendazole and dexamethasone is the first-line treatment Albendazole Praziquantel

Prevention is essential to decreasing prevalence in developing countries Strict meat inspection regulations Sewage treatment and disposal Health education

Is it possible to break the life cycle?

YES!

YES!

YES!

Is there a vaccine? The S3Pvac vaccine has been developed against porcine cysticercosis to break the transmission cycle. Effective, but not yet widely used.

Future Goals By 2015: ◦ Strategy for control and elimination T. solium By 2020: ◦ Interventions scaled up in Africa, Asia and Latin America for T. solium control and elimination Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases

References prevent-epilepsy-developing-world 7. main.pdf?_tid=06eeb4b047aadd2d242c65ea &acdnat= _80197ca b6b /epilepsy-neurocysticercosis-and-poverty-at-mphumaze-and-marhambeni-locations-in- south-africa.html