Neurocystercosis

FACTS

  • pork tapeworm (Taenia solium), incubation period months - decades
  • most common parasite in CNS
 

HPI

universal ROS
+ Hydro ROS
+ seizures (most common cause of acquired epilepsy in some countries)

PHYSICAL EXAM

IMAGING

cysts 1-2 cm diameter, signal intensity similar to CSF
notion image
A/P
#1) ID consult
#2) Medical treatment: steroids + anthelmintic drugs (praziquantel / albendazole) if no signs of hydro
#3) Reasons to operate
  • need a biopsy
  • spinal/intraventricular/subarachnoid cysts usually refractory to medical therapy
  • giant cysts > 50mm when intracranial hypertension persistent