Prehospital Care
Patients present with seizure activity, altered mental status, headache, or other neurologic complaints. Prehospital treatment involves standard supportive care including ensuring that adequate airway support, oxygenation, ventilation, and perfusion are maintained. Administration of anticonvulsants may be necessary for prolonged or repeated seizure activity. Empiric naloxone may be given for coma. Hypoglycemia should be corrected.
Emergency Department Care
Secure airway, oxygenation, circulation, adequate glucose delivery, and proper monitoring.
Administer supportive care for those presenting with seizure activity.
Correct metabolic abnormalities.
Anticonvulsants are reliably effective in controlling seizures secondary to cysticercosis. Most patients will respond to first-line agents.
Steroids, osmotic agents, and/or diuretics are indicated with evidence of increased ICP.
Analgesics may be administered for pain control.
Initiate diagnostic procedures, including blood work and imaging.
Consult appropriate specialists.
Consultations
Consultations may include neurosurgery, neurology, infectious diseases, and ophthalmology. Neurosurgical procedures are frequently required to relieve intracranial pressure extraparenchymal NCC or cysticercotic encephalitis. Biopsy or surgical removal of lesions may be necessary.
-
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.
