Neurocysticercosis

Neurocysticercosis is a major contributor to the burden of seizures in the world, and is also one of the few preventable causes of seizures and epilepsy (Garcia and Del Brutto 2005). The pig is the usual host of the larval stage of the pork tapeworm Taenia solium, a condition called porcine cysticercosis. However, the larvae or cysticerci can also infect the human host. Cysticercosis lesions in the human nervous system (neurocysticercosis: NCC) are a common cause of neurological morbidity in most developing countries, particularly seizures and intracranial hypertension. Highly endemic areas include Latin America, India, parts of China and Africa, Indonesia, and parts of the Asian Southeast. In these areas, cysticercosis is responsible for approximately one-third of all epilepsy cases. Serological evidence of exposure to the parasite can be found in 10–25% of the general population, and residual brain calcifications can also be found in 10% or more of the general population (Del Brutto et al. 2005; Medina et al. 2005; Montano et al. 2005). Because of increased immigration and travel patterns, NCC is now seen with some frequency in non-endemic, industrialized countries (Schantz et al. 1998). Mortality in NCC is associated with the presence of hydrocephalus or intracranial hypertension (associated with extraparenchymal NCC), and also with increased mortality in individuals with seizures. Extraparenchymal NCC carries a poor prognosis with a mortality that may reach 20%.