Neuroimaging in Neurocysticercosis Differential Diagnoses

  • Author: Arturo Carpio, MD; Chief Editor: Karen L Roos, MD   more...
 
Updated: Feb 6, 2012
 
 

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Arturo Carpio, MD  Director of Epilepsy Center, Professor, Department of Neurology, University of Cuenca School of Medicine, Ecuador; Senior Research Scientist of the GH Sergievsky Center, Columbia University

Arturo Carpio, MD is a member of the following medical societies: American Academy of Neurology

Disclosure: Nothing to disclose.

Coauthor(s)

Nicholas Lorenzo, MD  Consulting Staff, Neurology Specialists and Consultants

Nicholas Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, and American College of Physician Executives

Disclosure: Nothing to disclose.

Specialty Editor Board

Joseph F Hulihan, MD  Vice President, Medical Affairs, Ortho-McNeil Janssen Scientific Affairs, LLC

Joseph F Hulihan, MD is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, American Epilepsy Society, American Headache Society, and American Medical Association

Disclosure: Johnson & Johnson Salary Employment; Johnson & Johnson Stock Employment

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, Regional MS Center of Excellence, 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, 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
  1. Nash TE, Garcia HH. Diagnosis and treatment of neurocysticercosis. Nat Rev Neurol. Sep 13 2011;7(10):584-94. [Medline].

  2. Roy B, Verma S, Awasthi R, Rathore RK, Venkatesan R, Yoganathan SA, et al. Correlation of phase values with CT Hounsfield and R2* values in calcified neurocysticercosis. J Magn Reson Imaging. Nov 2011;34(5):1060-4. [Medline].

  3. Saenz B, Ruiz-Garcia M, Jimenez E, Hernandez-Aguilar J, Suastegui R, Larralde C. Neurocysticercosis: clinical, radiologic, and inflammatory differences between children and adults. Pediatr Infect Dis J. Sep 2006;25(9):801-3. [Medline].

  4. Das K, Mondal GP, Banerjee M, Mukherjee BB, Singh OP. Role of antiparasitic therapy for seizures and resolution of lesions in neurocysticercosis patients: an 8 year randomised study. J Clin Neurosci. Dec 2007;14(12):1172-7. [Medline].

  5. Gogia S, Talukdar B, Choudhury V, Arora BS. Neurocysticercosis in children: clinical findings and response to albendazole therapy in a randomized, double-blind, placebo-controlled trial in newly diagnosed cases. Trans R Soc Trop Med Hyg. Jul-Aug 2003;97(4):416-21. [Medline].

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

  7. Garcia HH, Pretell EJ, Gilman RH, Martinez SM, Moulton LH, Del Brutto OH. 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].

  8. Carpio A, Kelvin EA, Bagiella E, Leslie D, Leon P, Andrews H. Effects of albendazole treatment on neurocysticercosis: a randomised controlled trial. J Neurol Neurosurg Psychiatry. Sep 2008;79(9):1050-5. [Medline].

  9. Caplan LR. How to manage patients with neurocysticercosis. Eur Neurol. 1997;37(2):124. [Medline].

  10. Carpio A. Neurocysticercosis: an update. Lancet Infect Dis. Dec 2002;2(12):751-62. [Medline].

  11. Carpio A, Escobar A, Hauser WA. Cysticercosis and epilepsy: a critical review. Epilepsia. Oct 1998;39(10):1025-40. [Medline].

  12. Carpio A, Hauser WA. Prognosis for seizure recurrence in patients with newly diagnosed neurocysticercosis. Neurology. Dec 10 2002;59(11):1730-4. [Medline].

  13. Carpio A, Hauser WA. Neurocysticercosis and epilepsy. In: Singh G, Prabhakar S, eds. Taenia Solium Cysticercosis. Oxon, UK: CABI Publishing; 2002:211-20.

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

  15. Carpio A, Santillan F, Leon P. Is the course of neurocysticercosis modified by treatment with antihelminthic agents?. Arch Intern Med. Oct 9 1995;155(18):1982-8. [Medline].

  16. Correa D, Medina-Escutia, E. Host-parasite immune relationship in Taenia solium taeniosis and cysticercosis. In: Garcia HH, Martinez, SM eds. Taenia solium Taeniasis/Cysticercosis. 1999:15-24.

  17. Davis L. Neurocysticercosis and seizures: Avoiding the cost of antihelminthic treatment. Neurology. 2002;59:1669-71.

  18. Dixon HBF, Lipscomb FM. Cysticercosis: an analysis and follow up of 450 cases. Med Res Council Special Reports. 1961;299:1-58.

  19. Escobar A. The pathology of neurocysticercosis. Cysticercosis of Central Nervous System. 1983:27-54.

  20. Estanol B, Corona T, Abad P. A prognostic classification of cerebral cysticercosis: therapeutic implications. J Neurol Neurosurg Psychiatry. Oct 1986;49(10):1131-4. [Medline].

  21. Flisser A, Correa D, Evans CAW. Taenia solium cysticercosis: New revisited immunological aspects. In: Singh G, Prabhakar S, eds. Taenia Solium Cysticercosis. Oxon, UK: CABI Publish; 2002:24-44.

  22. Garcia HH, Martinez M, Gilman R. Diagnosis of cysticercosis in endemic regions. The Cysticercosis Working Group in Peru. Lancet. Aug 31 1991;338(8766):549-51. [Medline].

  23. Garg K, Singh K, Misra S. Single-enhancing lesions in Indians patients with seizures: a review. Epilepsy Res. 2002;59:1730-1734.

  24. Garg RK, Kar AM, Jain S. Failure of albendazole therapy in two common types of parenchymal neurocysticercosis. J Assoc Physicians India. Oct 1995;43(10):706-7. [Medline].

  25. Goodman KA, Ballagh SA, Carpio A. Case-control study of seropositivity for cysticercosis in Cuenca, Ecuador. Am J Trop Med Hyg. Jan 1999;60(1):70-4. [Medline].

  26. Kramer LD. Medical treatment of cysticercosis--ineffective. Arch Neurol. Jan 1995;52(1):101-2. [Medline].

  27. Kramer LD, Locke GE, Byrd SE. Cerebral cysticercosis: documentation of natural history with CT [published erratum appears in Radiology 1989 Oct;173(1):286]. Radiology. May 1989;171(2):459-62. [Medline].

  28. Manreza ML. Neurocysticercosis in children. Trends in Pediatric Neurology. 1993;295-8.

  29. Martinez HR, Rangel-Guerra R, Arredondo-Estrada JH. Medical and surgical treatment in neurocysticercosis a magnetic resonance study of 161 cases. J Neurol Sci. May 1995;130(1):25-34. [Medline].

  30. McCormick GF, Zee CS, Heiden J. Cysticercosis cerebri. Review of 127 cases. Arch Neurol. Sep 1982;39(9):534-9. [Medline].

  31. Mitchell WG, Crawford TO. Intraparenchymal cerebral cysticercosis in children: diagnosis and treatment. Pediatrics. Jul 1988;82(1):76-82. [Medline].

  32. Padma MV, Behari M, Misra NK. Albendazole in single CT ring lesions in epilepsy. Neurology. Jul 1994;44(7):1344-6. [Medline].

  33. Pal DK, Carpio A, Sander JW. Neurocysticercosis and epilepsy in developing countries. J Neurol Neurosurg Psychiatry. Feb 2000;68(2):137-43. [Medline].

  34. Ramos-Kuri M, Montoya RM, Padilla A. Immunodiagnosis of neurocysticercosis. Disappointing performance of serology (enzyme-linked immunosorbent assay) in an unbiased sample of neurological patients. Arch Neurol. Jun 1992;49(6):633-6. [Medline].

  35. Schantz PM. Cysticercosis in non-endemic countries: the example of United States. Teniasis/Cysticercosis por T. solium. 1996;277-86.

  36. Singhal BS, Salinas RA. Controversies in the Drug Treatment of Neurocysticercosis. In: Singh G, Prabhakar S, eds. Taenia Solium Cysticercosis. Oxon, UK: CABI Publish; 2002:713-43.

  37. Suss RA, Maravilla KR, Thompson J. MR imaging of intracranial cysticercosis: comparison with CT and anatomopathologic features. AJNR Am J Neuroradiol. Mar-Apr 1986;7(2):235-42. [Medline].

  38. Teitelbaum GP, Otto RJ, Watanabe AT. MR imaging of neurocysticercosis. AJNR. 1989;10:709-18.

  39. Tsang VC, Brand JA, Boyer AE. An enzyme-linked immunoelectrotransfer blot assay and glycoprotein antigens for diagnosing human cysticercosis (Taenia solium). J Infect Dis. Jan 1989;159(1):100-2. [Medline].

  40. White AC, Garcia HH. Recent Developments in the Epidemiology, Diagnosis, Treatment, and Prevention of Neurocysticercosis. Curr Infect Dis Rep. Dec 1999;1(5):434-440. [Medline].

  41. Xiao ZX, Zhao CY, Liu YP. [Albendazole treatment in cerebral cysticercosis]. Chung Hua Nei Ko Tsa Chih. Feb 1986;25(2):100-2, 127. [Medline].

  42. Zee CS, Segall HD, Destian S. MRI of intraventricular cysticercosis: surgical implications. J Comput Assist Tomogr. Nov-Dec 1993;17(6):932-9. [Medline].

Previous
Next
 
Neuroimaging in neurocysticercosis. CT scans showing different phases of neurocysticercosis. Top left: CT scan showing many calcifications and active cysts with scolices in both hemispheres. Top right: T1-weighted MRI showing 2 active cysts with the scolex in their interior (vesicular phase). Bottom left: Postcontrast CT scan showing a ring-enhancing cyst (colloidal phase) on left. Bottom right: Proton density-weighted MRI showing a thick capsule with adjacent scolex and perilesional edema (colloidal phase).
Neuroimaging in neurocysticercosis. Natural history of neurocysticercosis. Top left: This CT scan shows a large occipital active cyst (vesicle phase), many calcifications, and small cortical cysts. Top right: After 18 months, the occipital cyst has been replaced by a calcification and the remaining cysts have disappeared. Bottom left: A single parietal nodular-enhancing lesion (transitional, nodular-granular phase) is shown. Bottom right: Six months later, the lesion has disappeared.
Neuroimaging in neurocysticercosis. Noncontrast and contrast-enhanced CT scan of neurocysticercosis. Left: Normal noncontrast CT scan. Right: After administration of the contrast medium, the CT scan of the same patient shows a single parietal nodular-enhancing lesion (transitional, nodular phase).
Neuroimaging in neurocysticercosis. Cysticercotic encephalitis. Left: Contrast-enhanced CT scan showing multiple, small, nodular, and annular areas of abnormal enhancement in brain parenchyma. Right: Gadolinium-enhanced T1-weighted MRI showing hyperintense lesions.
Neuroimaging in neurocysticercosis. Cysticercus cellulosae in neurocysticercosis.
Treatment of Neurocysticercosis
Neuroimaging in neurocysticercosis. Cysticercus cellulosae showing the invaginated scolex in neurocysticercosis.
Neuroimaging in neurocysticercosis. Subcortical parenchymatous cysticercosis
Neuroimaging in neurocysticercosis. Inflammatory reaction in parenchymatous cysticercosis.
Neuroimaging in neurocysticercosis. Antiepileptic treatment for patients with first seizure due to neurocysticercosis.
Neuroimaging in neurocysticercosis. Probability of seizure recurrence (Kaplan-Meier curve) after a first seizure in patients with NC as function of cysticidal treatment.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
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.