Neurocysticercosis: parasitology, clinical presentation, diagnosis, and recent advances in management.

Cysticercosis, which is the most common parasitic cause of neurological disease in man, consists of infection by the larval stage (Cysticercus cellulosae) [1] of the pig tapeworm Taenia solium. The disease was described in pigs by Aristophanes and Aristotle in the third century BC, but Paranoli is credited with the first human account (involving the corpus callosum) in 1550 [2]. The term cysticercus was first used by Laennec. One of the largest series of cases was documented by Dixon and Lipscomb in British soldiers and their families in India [3]; 92 per cent of 450 affected individuals described had a history of epilepsy. Although accurate information on prevalence rates is rarely available, the disease is known to be endemic in all continents with the exception of Australasia [4]; however, even there cases in immigrants are now being identified. Exceptionally high rates exist in Latin America-from Mexico to Chile. In Mexico City 1.4—3.6 per cent of autopsies in the general population provide evidence of cysticercosis [1]; the disease accounts for approximately 10 per cent of neurological admissions, as well as up to one-third of craniotomies for intracranial space-occupying lesions. Important foci exist in the USSR, China, India, Pakistan, the Philippines and Indonesia [5], and the disease occurs sporadically throughout Africa. Although now rare in northern Europe, it remains a problem in the Iberian peninsula and the Slavic countries. In north America, the disease is overall unusual; however, during the last decade it has become a significant problem in immigrant populations [6]. Cysticercosis is overall unusual in Jews and Muslims because pork consumption in these ethnic groups is generally low; however, this fact does not prevent ingestion of T. solium eggs in contaminated food or water. This, and not uncooked pork ingestion is the cause of human cysticercosis. The highest prevalence rates therefore exist in communities where there is a close contact between man and pigs, pork is eaten raw or undercooked, and most importantly where hygienic standards and practices are low. Affected communities are often rural ones [5]. Faecal contamination of foodstuffs is the usual source of infection; however flies have been shown to play a

[1]  J. Rodríguez-Carbajal,et al.  Neuroradiology of human neurocysticercosis. , 1990 .

[2]  R. Brereton Selective indications for the use of praziquantel in the treatment of brain cysticercosis , 1988 .

[3]  P. Mason,et al.  Serological diagnosis of neurocysticercosis: evaluation of ELISA tests using cyst fluid and other components of Taenia solium cysticerci as antigens. , 1988, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[4]  P. Azimi,et al.  Cerebral cysticercosis in a 22-month-old infant. , 1987, American journal of clinical pathology.

[5]  C. Filley,et al.  Neurocysticercosis in the United States: 35 cases and a review. , 1987, Reviews of infectious diseases.

[6]  G. Pradilla,et al.  Use of enzyme-linked immunosorbent assay in the diagnosis of cysticercosis. , 1987, Archives of neurology.

[7]  L. Dufour,et al.  Detection of Cysticercus cellulosae antigens in cerebrospinal fluid by dot enzyme-linked immunosorbent assay (Dot-ELISA) and standard ELISA. , 1987, The American journal of tropical medicine and hygiene.

[8]  J. D. Lopes,et al.  Immunodiagnosis of human cysticercosis (Taenia solium) with antigens purified by monoclonal antibodies , 1987, Journal of clinical microbiology.

[9]  E. Rossouw,et al.  Diagnosis of neurocysticercosis by enzyme-linked immunosorbent assay. , 1987, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[10]  J. Sotelo,et al.  Albendazole therapy for neurocysticercosis. , 1987, Archives of internal medicine.

[11]  J. Catford,et al.  Human cysticercosis and intestinal parasitism amongst the Ekari people of Irian Jaya. , 1987, The Journal of tropical medicine and hygiene.

[12]  S. Galindo-Virgen,et al.  Long-term results of praziquantel therapy in neurocysticercosis. , 1987, Journal of neurosurgery.

[13]  N. Saines,et al.  Cerebral cysticercosis: a case report with particular reference to recent advances in diagnosis and treatment. , 1987, Australian and New Zealand journal of medicine.

[14]  H. Horowitz,et al.  Case 11-1986: cysticercosis. , 1987, The New England journal of medicine.

[15]  A. Flisser,et al.  Characterization by enzyme-linked immunosorbent assay of the humoral immune response in patients with neurocysticercosis and its application in immunodiagnosis , 1986, Journal of clinical microbiology.

[16]  B. Estañol,et al.  Anticysticercous antibodies in serum and cerebrospinal fluid in patients with cerebral cysticercosis. , 1986, Journal of neurology, neurosurgery, and psychiatry.

[17]  R. Norman,et al.  Cerebral cysticercosis: treatment with praziquantel. , 1986, Pediatrics.

[18]  J. Sotelo,et al.  ELISA in the diagnosis of neurocysticercosis. , 1986, Archives of neurology.

[19]  G. Royal Hunter's Tropical Medicine, ed 6 , 1985 .

[20]  M. E. Jones Hunter's Tropical Medicine, 6th Edn., G. Thomas Strickland (Ed.). W. B. Saunders Company, Edinburgh (1984), 1057 , 1984 .

[21]  F. Rubio-Donnadieu,et al.  Therapy of Parenchymal Brain Cysticercosis with Praziquantel , 1984 .

[22]  A. Valavanis,et al.  Cerebral cysticercosis: treatment with praziquantel. Report of two cases. , 1984, The American journal of tropical medicine and hygiene.

[23]  Praziquantel for cysticercosis of the brain parenchyma. , 1984, The New England journal of medicine.

[24]  R. Norman,et al.  Cerebral cysticercosis treated biphasically with dexamethasone and praziquantel. , 1983, Annals of internal medicine.

[25]  W. Wiederholt,et al.  Cysticercosis. An old scourge revisited. , 1982, Archives of neurology.

[26]  C. Zee,et al.  Cysticercosis cerebri. Review of 127 cases. , 1982, Archives of neurology.

[27]  S. Castaño,et al.  Treatment of cysticercosis with praziquantel in Colombia. , 1982, The American journal of tropical medicine and hygiene.

[28]  H. Mehlhorn,et al.  New results on the effect of praziquantel in experimental cysticercosis. , 1982, The American journal of tropical medicine and hygiene.

[29]  R. Yolken,et al.  Enzyme-linked immunosorbent assay (ELISA) for the detection of antibody to cysticerci of Taenia solium. , 1982, The American journal of tropical medicine and hygiene.

[30]  J. Nóbrega,et al.  Administration of praziquantel in neurocysticercosis. , 1982, Tropenmedizin und Parasitologie.

[31]  W. Wiederholt,et al.  CNS cysticercosis. , 1982, Archives of neurology.

[32]  A. Flisser,et al.  Immunodiagnosis of human cysticercosis: ELISA and immunoelectrophoresis. , 1982 .

[33]  A. Flisser,et al.  Cysticercosis: present state of knowledge and perspectives. , 1982 .

[34]  A. Flisser,et al.  The immunology of human and animal cysticercosis: a review. , 1979, Bulletin of the World Health Organization.

[35]  I. Macleod,et al.  Cysticercosis and epilepsy in Africans: a clinical and serological study. , 1966, Annals of tropical medicine and parasitology.

[36]  H. Valladares,et al.  [Surgical treatment of cerebral cysticercosis]. , 1961, Neurocirugia.

[37]  H. Dixon,et al.  Cysticercosis , 1962, Neurology.

[38]  M. P. Ravenel Manson's Tropical Diseases (10th ed.) , 1936 .