All of the following are true of Neurocysticercosis EXCEPT
Albendazole is the drug of choice
More common in vegetarians
Produces intracerebral calcification
Man is the definitive host
(B) More common in vegetarians # NEUROCYSTICERCOSIS (NCC) is caused by the CNS infection with the pork tapeworm Taenia solium, which is endenic in most low-income countries where pigs are raised.> Perpetuation of this parasitic disease is related to poor sanitation and hygiene.> Clinical presentation: There is a variable time interval between the point of infection and the onset of symptoms (ranging from 1-30 years).> Clinical presentation includes: Seizures: most common symptom and most common cause of seizures in young adults in endemic areas 2 Headaches, Hydrocephalus, Altered mental status, Neurological deficits> CSF serology may be helpful with the initial diagnosis especially in cases of intraventricular/subarachnoid infection.> Pathology: Infection causes extra-intestinal disease (Neurocysticercosis) usually occurs as a result of eating food or drinking water contaminated by human faeces containing T. solium eggs.> This is distinct from the 'normal' life cycle in which the under cooked pork is eaten and the larval cysts contained within, mature into adult intestinal tapeworm.> Extra-intestinal infection changes to specific clinical & imaging occurs progression in four stages of infection.# Escobar's pathological stages:> There are four main stages: Vesicular: Viable parasite with intact membrane and therefore no host reaction. Colloidal vesicular: Parasite dies within 4-5 years 1 untreated, or earlier with treatment and the cyst fluid becomes turbid. As the membrane becomes leaky oedema surrounds the cyst. This is the most symptomatic stage. Granular Nodular: Oedema decreases as the cyst retracts further; enhancement persists. Nodular calcified: End-stage quiescent calcified cyst remnant; no oedema.> Location: Infection can be both intra and extra axial. Subarachnoid space over the cerebral hemispheres (can be very large): most commonly located parenchyma. Second most common location is seen near grey matter (frequently seen}-white matter junction basal cisterns may be "grape like" (racemose): most lack an identifiable scolex ventricles usually solitary cysts 4th ventricle most frequent Typically the parenchymal cysts are small (1cm) whereas the subarachnoid cysts can be much bigger (up to 9 cm): differential therefore being arachnoid cyst. It is the most common cause of epilepsy in endemic areas (Southeast Asia, South America) with progression through the four stages taking anywhere between 1 to 9 years.
Miscellaneous