Cysticercosis in Emergency Medicine Clinical Presentation

  • Author: Ryan Tenzer, MD, FAAEM; Chief Editor: Barry E Brenner, MD, PhD, FACEP   more...
 
Updated: Mar 22, 2012
 

History

  • Neurocysticercosis (NCC) is frequently asymptomatic. Symptoms are generally similar to those found with other intracranial mass lesions, which may be consistent with increased ICP. Cysticercosis of other tissues is almost always asymptomatic. The following symptoms can appear years after infection begins:
    • Seizures (focal or generalized) in 70-90% of patients
    • Chronic headache
    • Nausea and vomiting
    • Vision changes
    • Focal neurological complaints
    • Mental status change
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Physical

  • Physical findings include the following:
    • Absence of fever
    • Usually nonfocal neurologic examination findings
    • Papilledema and decreased retinal venous pulsations
    • Meningismus
    • Hyperreflexia
    • Nystagmus or visual deficits
    • Visualization of intraocular larvae by funduscopy may be diagnostic
    • Subcutaneous nodules resembling sebaceous cysts
    • Muscular pseudohypertrophy
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Causes

  • Risk factors associated with cysticercosis include the following:
    • Immigration from an endemic area (especially Mexico, Latin America)
    • Family history of parasitic infestation
    • History of travel to an endemic area
    • Household visitors from an endemic area
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Contributor Information and Disclosures
Author

Ryan Tenzer, MD, FAAEM  Clinical Assistant Professor of Emergency Medicine, Penn State College of Medicine; Consulting Staff, Department of Emergency Medicine, Lehigh Valley Hospital

Ryan Tenzer, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Howard A Blumstein, MD, FAAEM  Assistant Professor of Surgery, Medical Director, Department of Emergency Medicine, Wake Forest University School of Medicine

Howard A Blumstein, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Emergency Medicine Residents Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

William K Chiang, MD  Associate Professor, Department of Emergency Medicine, New York University School of Medicine; Chief of Service, Department of Emergency Medicine, Bellevue Hospital Center

William K Chiang, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Medical Toxicology, and Society for Academic Emergency Medicine

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

Barry J Sheridan, DO  Chief Warrior in Transition Services, Brooke Army Medical Center

Barry J Sheridan, DO is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP  Professor of Emergency Medicine, Professor of Internal Medicine, Program Director for Emergency Medicine, Case Medical Center, University Hospitals, Case Western Reserve University School of Medicine

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

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Nonenhanced CT scan of the brain demonstrates the multiple calcified lesions of inactive parenchymal neurocysticercosis.
Enhanced CT scan of the brain in a patient with neurocysticercosis demonstrates a live cyst with a minimally enhancing wall and an eccentric hyperattenuating scolex.
Nonenhanced (left) and enhanced (right) CT scans of the brain in a patient with neurocysticercosis show multiple ring-enhancing lesions with perifocal edema.
 
 
 
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