Neurocysticercosis(cysticercosis)

Krizia del RosarioApril 12, 2012

http://www.human-healths.com/taenia-solium/taenia-solium.php

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-

1890http://www.sciencedirect.com/science/article/pii/S1286457900013368

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

http://www.astrium.com/Cysticercose.html

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

http://www.cdc.gov/parasites/cysticercosis/biology.html

The cyst undergoes 4 distinct stages

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

Stage 1: Vesicular cyst

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

Stage 2: Colloidal cyst

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

Stage 3: Nodular cyst

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

Stage 4: Calcified cyst

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

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: http://reference.medscape.com/features/slideshow/neurocysticercosis

How do we treat this disease?

Antihelminthic medicationsCo-administration of anti-

inflammatoriesAnticonvulsant therapy to

manage seizuresSurgery

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 regulationsSewage treatment and disposalHealth education

Is it possible to break the life cycle?

http://www.cdc.gov/parasites/cysticercosis/biology.html

YES!

http://www.cdc.gov/parasites/cysticercosis/biology.html

YES!

http://www.cdc.gov/parasites/cysticercosis/biology.html

YES!

http://www.cdc.gov/parasites/cysticercosis/biology.html

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 GoalsBy 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

References1. 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.html5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/pdf/epc_43008.pdf6. http://www.galvmed.org/news-resources/content/global-collaboration-produce-

vaccine-help-prevent-epilepsy-developing-world7. http://ac.els-cdn.com/S0264410X12001934/1-s2.0-S0264410X12001934-

main.pdf?_tid=06eeb4b047aadd2d242c65ea01540446&acdnat=1333505466_80197ca3184403236770733b6b663675

8. http://www.sciencedirect.com/science/article/pii/S0264410X060033799. http://www.springerlink.com/content/675385504w070160/fulltext.pdf10. http://whqlibdoc.who.int/hq/2012/WHO_HTM_NTD_2012.1_eng.pdf11. http://www.ajtmh.org/content/72/1/3/F2.expansion?ck=nck12. http://neurosurgery.ucla.edu/body.cfm?id=18613. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/14. http://www.sciencedirect.com/science/article/pii/S128645790001336815. 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.001128717. http://emedicine.medscape.com/article/1168784-overview