1. Neurocysticercosis (cysticercosis) Krizia del Rosario April 12, 2012 http://www.human-healths.com/taenia-solium/taenia-solium.php

2. Caused by larval cysts (cysticerci) of the pork tapeworm Taenia solium http://www.human-healths.com/taenia- solium/taenia-solium.php Sciutto et al. Microbes and Infection 2000. 2: 1875-1890 http://www.sciencedirect.com/science/article/pii/S1286457900013368

3. Endemic in Mexico, Central and South America, and parts of Africa, Asia and India http://www.astrium.com/Cysticercose.html

4. 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

5. Life Cycle of Taenia solium http://www.cdc.gov/parasites/cysticercosis/biology.html

6. The cyst undergoes 4 distinct stages DeGiorgio et al. Epilepsy Currents 2004, 4: 107-111 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/

7. Stage 1: Vesicular cyst DeGiorgio et al. Epilepsy Currents 2004, 4: 107-111 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/

8. Stage 2: Colloidal cyst DeGiorgio et al. Epilepsy Currents 2004, 4: 107-111 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/

9. Stage 3: Nodular cyst DeGiorgio et al. Epilepsy Currents 2004, 4: 107-111 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/

10. Stage 4: Calcified cyst DeGiorgio et al. Epilepsy Currents 2004, 4: 107-111 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/

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

12. Serological testing, CT scans and MRI scans are used to detect neurocysticercosis Source: http://reference.medscape.com/features/slid eshow/neurocysticercosis

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

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

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

16. Is it possible to break the life cycle? http://www.cdc.gov/parasites/cysticercosis/biology.html

17. YES!

18. YES!

19. YES!

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

21. 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

22. References 1. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001651/ 2. http://www.cdc.gov/parasites/cysticercosis/ 3. http://www.who.int/zoonoses/diseases/taeniasis/en/ 4. http://www.aafp.org/afp/2007/0701/p91.html 5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/pdf/epc_43008.pdf 6. http://www.galvmed.org/news-resources/content/global-collaboration-produce-vaccine-help- prevent-epilepsy-developing-world 7. http://ac.els-cdn.com/S0264410X12001934/1-s2.0-S0264410X12001934- main.pdf?_tid=06eeb4b047aadd2d242c65ea01540446&acdnat=1333505466_80197ca318440 3236770733b6b663675 8. http://www.sciencedirect.com/science/article/pii/S0264410X06003379 9. http://www.springerlink.com/content/675385504w070160/fulltext.pdf 10. http://whqlibdoc.who.int/hq/2012/WHO_HTM_NTD_2012.1_eng.pdf 11. http://www.ajtmh.org/content/72/1/3/F2.expansion?ck=nck 12. http://neurosurgery.ucla.edu/body.cfm?id=186 13. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/ 14. http://www.sciencedirect.com/science/article/pii/S1286457900013368 15. http://www.ispub.com/journal/the-internet-journal-of-neurology/volume-7-number- 1/epilepsy-neurocysticercosis-and-poverty-at-mphumaze-and-marhambeni-locations-in- south-africa.html 16. http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0011287 17. http://emedicine.medscape.com/article/1168784-overview