eMedicine Specialties > Neurology > Neurological Infections

Neurocysticercosis: Follow-up

Author: Mohammed J Zafar, MD, FAAN, Associate Clinical Professor of Medicine, Kalamazoo Center for Medical Studies, Michigan State University; NeuroImager, Premier Medical Care, PC, Premier Radiology, Kalamazoo Neurologic Institute.
Contributor Information and Disclosures

Updated: Jul 1, 2009

Follow-up

Further Outpatient Care

  • Intracerebral lesions can cause epilepsy in the future. Administration of antiepileptic medication is the same as in any other epileptic syndrome.
  • Follow-up imaging study is recommended after 2-3 months, especially in cases in which anticysticercal medications are used as a diagnostic tool. The use of imaging will guide the requirement of future trials of anticysticercal medication in cases of subarachnoid cysticercosis.

Complications

Chronic epilepsy is one of the most frequent complications of neurocysticercosis. Others include headaches, neurological deficits related to strokes, and hydrocephalus.

Prognosis

  • In most patients, the prognosis is good.
  • Associated seizures seem to improve after treatment with anticysticercal drugs and, once treated, seizures are controlled by a first-line antiepileptic agent. Duration of treatment, as already mentioned, is not defined.
  • Patients with complications such as hydrocephalus, large cysts, multiple lesions with edema, chronic meningitis, and vasculitis are acutely ill and do not respond very well to treatment. Frequently, they have complications due to medical and surgical therapy.

Patient Education

  • Neurocysticercosis is a major public health problem in developing countries and is emerging as an increasingly important condition in regions in which the disease is not endemic. Comprehensive programs of long-term intervention involve appropriate legislation, health education, modernization of swine husbandry practices, improvement of efficiency and coverage of meat inspection, provision of adequate sanitary facilities, and measures to detect and treat human tapeworm carriers.
  • Political and economic realities in many communities where T solium is endemic today provide little hope that all these goals can be achieved in the near future. However, short-term approaches can be effective in the long-term, and these include educational campaigns in personal hygiene and general sanitation within the disease-endemic area.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Jorge G Burneo, MD, MSPH to the development and writing of this article.



More on Neurocysticercosis

Overview: Neurocysticercosis
Differential Diagnoses & Workup: Neurocysticercosis
Treatment & Medication: Neurocysticercosis
Follow-up: Neurocysticercosis
Multimedia: Neurocysticercosis
References
[ CLOSE WINDOW ]

References

  1. Bickerstaff ER, Cloake PC, Hughes B, Smith WT. The racemose form of cerebral cysticercosis. Brain. Mar 1952;75(1):1-18. [Medline].

  2. Del Brutto OH, Santibanez R, Noboa CA, et al. Epilepsy due to neurocysticercosis: analysis of 203 patients. Neurology. Feb 1992;42(2):389-92. [Medline].

  3. Del Brutto OH, Garcia E, Talamas O, Sotelo J. Sex-related severity of inflammation in parenchymal brain cysticercosis. Arch Intern Med. Mar 1988;148(3):544-6. [Medline].

  4. Gaffo AL, Guillen-Pinto D, Campos-Olazabal P, Burneo JG. [Cysticercosis as the main cause of partial seizures in children in Peru]. Rev Neurol. Nov 16-30 2004;39(10):924-6. [Medline].

  5. Barinagarrementeria F, Cantu C. Neurocysticercosis as a cause of stroke. Stroke. Aug 1992;23(8):1180-1. [Medline].

  6. Barinagarrementeria F, Del Brutto OH. Lacunar syndrome due to neurocysticercosis. Arch Neurol. Apr 1989;46(4):415-7. [Medline].

  7. Garcia HH, Martinez SM. Taenia solium/cysticercosis. Lima: Editorial Universo. 1999.

  8. Garcia HH, Pretell EJ, Gilman RH, et al. A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis. N Engl J Med. Jan 15 2004;350(3):249-58. [Medline].

  9. Garg RK. Medical management of neurocysticercosis. Neurol India. Dec 2001;49(4):329-37. [Medline].

  10. Sotelo J, Escobedo F, Penagos P. Albendazole vs praziquantel for therapy for neurocysticercosis. A controlled trial. Arch Neurol. May 1988;45(5):532-4. [Medline].

  11. Proano JV, Madrazo I, Avelar F, et al. Medical treatment for neurocysticercosis characterized by giant subarachnoid cysts. N Engl J Med. Sep 20 2001;345(12):879-85. [Medline].

  12. Bittencourt PR, Gracia CM, Martins R, et al. Phenytoin and carbamazepine decreased oral bioavailability of praziquantel. Neurology. Mar 1992;42(3 Pt 1):492-6. [Medline].

  13. Boecher-Schwarz HG, Hey O, Higer HP, Perneczky A. Intrasellar cysticercosis mimicking a pituitary adenoma. Br J Neurosurg. 1991;5(4):405-7. [Medline].

  14. Cardenas F, Quiroz H, Plancarte A, et al. Taenia solium ocular cysticercosis: findings in 30 cases. Ann Ophthalmol. Jan 1992;24(1):25-8. [Medline].

  15. Carpio A, Placencia M, Santillan F, Escobar A. A proposal for classification of neurocysticercosis. Can J Neurol Sci. Feb 1994;21(1):43-7. [Medline].

  16. Case records of the Massachusetts General Hospital. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 26-1994. A 20-year-old Philippine woman with a soft-tissue mass in the forearm. N Engl J Med. Jun 30 1994;330(26):1887-93. [Medline].

  17. Del Brutto OH. [Neurocisticercosis]. 1998;[Full Text].

  18. del Brutto OH. [Neurocysticercosis]. Rev Neurol. Sep 1-15 1999;29(5):456-66. [Medline].

  19. [Best Evidence] Del Brutto OH, Roos KL, Coffey CS, Garcia HH. Meta-analysis: Cysticidal drugs for neurocysticercosis: albendazole and praziquantel. Ann Intern Med. Jul 4 2006;145(1):43-51. [Medline].

  20. Del Brutto OH, Sotelo J, Roman GC. Neurocysticercosis: A Clinical Handbook. Vol 1. Lisse: Swets & Zeitlinger;1988.

  21. Garcia HH, Del Brutto OH. Heavy nonencephalitic cerebral cysticercosis in tapeworm carriers. The Cysticercosis Working Group in Perú. Neurology. Oct 22 1999;53(7):1582-4. [Medline].

  22. Garcia HH, Gilman R, Martinez M, et al. Cysticercosis as a major cause of epilepsy in Peru. The Cysticercosis Working Group in Peru (CWG). Lancet. Jan 23 1993;341(8839):197-200. [Medline].

  23. Garcia HH, Gilman RH, Gonzales AE. Epidemiology of Tenia solium infection in Peru. Cysticercosis Working Group Peru. In: Garcia HH, Martinez SM. Taenia Solium Taeniasis/Cysticercosis. 1999:297-305.

  24. Garg RK. Neurocysticercosis. Postgrad Med J. Jun 1998;74(872):321-6. [Medline].

  25. Gemmel M, Matyas Z, Pawlosky Z. Guidelines for surveillance, prevention and control of taeniasis/cysticercosis. Geneva: WHO. 1983.

  26. Grisolia JS, Wiederholt WC. CNS cysticercosis. Arch Neurol. Sep 1982;39(9):540-4. [Medline].

  27. Isidro-Llorens A, Dachs F, Vidal J, Sarrias M. Spinal cysticercosis. Case report and review. Paraplegia. Feb 1993;31(2):128-30. [Medline].

  28. Lopez-Hernandez A, Garaizar C. Childhood cerebral cysticercosis: clinical features and computed tomographic findings in 89 Mexican children. Can J Neurol Sci. Nov 1982;9(4):401-7. [Medline].

  29. Miller BL, Staugaitis SM, Tourtellotte WW, et al. Intra-blood-brain barrier IgG synthesis in cerebral cysticercosis. Arch Neurol. Aug 1985;42(8):782-4. [Medline].

  30. Monteiro L, Coelho T, Stocker A. Neurocysticercosis--a review of 231 cases. Infection. Mar-Apr 1992;20(2):61-5. [Medline].

  31. Puri V, Chowdhury V, Gulati P. Myoclonus: a manifestation of neurocysticercosis. Postgrad Med J. Jan 1991;67(783):68-9. [Medline].

  32. Sotelo J, Guerrero V, Rubio F. Neurocysticercosis: a new classification based on active and inactive forms. A study of 753 cases. Arch Intern Med. Mar 1985;145(3):442-5. [Medline].

  33. Soto-Hernandez JL, Gomez-Llata Andrade S, Rojas-Echeverri LA, et al. Subarachnoid hemorrhage secondary to a ruptured inflammatory aneurysm: a possible manifestation of neurocysticercosis: case report. Neurosurgery. Jan 1996;38(1):197-9; discussion 199-200. [Medline].

  34. Wallin MT, Kurtzke JF. Neurocysticercosis in the United States: review of an important emerging infection. Neurology. Nov 9 2004;63(9):1559-64. [Medline].

  35. White AC. Neurocysticercosis: a major cause of neurological disease worldwide. Clin Infect Dis. Feb 1997;24(2):101-13; quiz 114-5. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

NCC, parasitic disease, cerebral cysticercosis, Taenia solium, taeniasis, tapeworm, teniasis, pork tapeworm, cysticerci, subcutaneous cysticercosis, epilepsy, seizures, subarachnoid cysticercosis

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Mohammed J Zafar, MD, FAAN, Associate Clinical Professor of Medicine, Kalamazoo Center for Medical Studies, Michigan State University; NeuroImager, Premier Medical Care, PC, Premier Radiology, Kalamazoo Neurologic Institute.
Mohammed J Zafar, MD, FAAN is a member of the following medical societies: American Academy of Neurology, American Medical Association, American Society of Neuroimaging, and Michigan State Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Amy A Pruitt, MD, Associate Professor of Neurology, University of Pennsylvania; 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.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

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; Professor, Department of Neurology and Psychiatry, Associate Professor, Institute for Molecular Virology, and Department of Molecular Microbiology and Immunology, St Louis University
Florian P Thomas, MD, MA, PhD, Drmed is a member of the following medical societies: American Academy of Neurology, American Paraplegia Society, and National Multiple Sclerosis Society
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Nicholas Y Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Y Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.