Neurocysticercosis Differential Diagnoses

  • Author: Mohammed J Zafar, MD, FAAN; Chief Editor: Karen L Roos, MD   more...
 
Updated: Jun 7, 2011
 
 

Diagnostic Considerations

Neurocysticercosis poses a complex diagnostic and treatment dilemma, because its presentation depends on the locations of the lesions, the number of parasites, and the host's immune response, as well as any symptoms.

Other problems to be considered in the evaluation of suspected neurocysticercosis include the following:

  • Brain abscess
  • Brainstem gliomas
  • Cerebral amebiasis
  • Central nervous system (CNS) tumors
  • Chronic paroxysmal hemicrania
  • CNS toxoplasmosis
  • CNS cryptococcosis
  • Craniopharyngioma
  • Mycotic granulomas
  • Neurosarcoidosis
  • Oligodendroglioma
  • Pituitary tumors
  • Tuberculous meningitis
  • Tuberculosis of the CNS
  • Carotid disease and stroke

Stages of T solium involution

While in the nervous system, the T solium parasite goes through different stages of involution, which include the following:

  • Vesicular stage: A viable parasite with a mild inflammatory reaction
  • Colloidal stage: A parasite with a scolex in the process of degeneration and a severe inflammatory reaction around it
  • Granular stage: A parasite with a degenerated scolex and astrocytic gliosis around the cyst
  • Calcified stage: A parasite transformed into a calcified nodule with intense gliosis around the cyst.

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Mohammed J Zafar, MD, FAAN  Associate Clinical Professor of Medicine, Kalamazoo Center for Medical Studies, Michigan State University College of Human Medicine; Neurologist, Clinical Neurophysiologist and Neuroimager, Kalamazoo Nerve Center, PLLC

Mohammed J Zafar, MD, FAAN is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American Society of Neuroimaging, Michigan State Medical Society, and Movement Disorders Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Amy A Pruitt, MD  Associate Professor of Neurology, University of Pennsylvania School of Medicine; Attending Neurologist, Hospital of the University of Pennsylvania

Amy A Pruitt, MD is a member of the following medical societies: American Academy of Neurology

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Florian P Thomas, MD, MA, PhD, Drmed  Director, Spinal Cord Injury Unit, St Louis Veterans Affairs Medical Center; Director, National MS Society Multiple Sclerosis Center; Director, Neuropathy Association Center of Excellence, Professor, Department of Neurology and Psychiatry, Associate Professor, Institute for Molecular Virology, and Department of Molecular Microbiology and Immunology, St Louis University School of Medicine

Florian P Thomas, MD, MA, PhD, Drmed is a member of the following medical societies: American Academy of Neurology, American Neurological Association, American Paraplegia Society, Consortium of Multiple Sclerosis Centers, and National Multiple Sclerosis Society

Disclosure: Nothing to disclose.

Chief Editor

Karen L Roos, MD  John and Nancy Nelson Professor of Neurology, Professor of Neurological Surgery, Department of Neurology, Indiana University School of Medicine

Karen L Roos, MD is a member of the following medical societies: American Academy of Neurology and American Neurological Association

Disclosure: Nothing to disclose.

References

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Massive nonencephalitic neurocysticercosis. Photo courtesy of Cysticercosis Working Group in Peru.
Computed tomographic (CT) scan of the brain in a patient who presented with an episode of generalized tonic-clonic seizure. Note the calcified lesion in the left parieto-occipital region. Subsequent evaluation confirmed the diagnosis of neurocysticercosis.
T2-weighted magnetic resonance image (MRI) of the brain showing the presence of increased signal as a result of edema in the right frontal region; subsequent studies found a cysticercus in that location.
Magnetic resonance image (MRI) of the brain in a patient who presented with an episode of generalized tonic-clonic seizure. Note the cyst in the left parieto-occipital region with perilesional edema.
 
 
 
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