Neurocysticercosis

Neurocysticercosis is a helminthic neurological infection that characteristically manifests as acquired epilepsy.

Neurocysticercosis is caused by the tapeworm Taenia solium, and is acquired via the fecal-oral route, by ingestion of Taenia solium eggs found in the feces of an infected human carrier. Taenia solium is endemic in most low-income countries where pigs are raised. After eggs are ingested, they hatch in the intestine and release oncospheres, which penetrate the intestinal wall. Among other organs, oncospheres travel to the brain, where they develop into cysticerci and lead to neurocystercosis.

The incidence of neurocysticercosis in the US is estimated at 0.2-0.6 cases per 100,000 person-years. In the Hispanic population, the incidence is estimated at 1.5-5.8 cases per 100,000 person-years.

Although no pathognomonic clinical picture exists, adult-onset seizures in patients living in endemic regions are highly suggestive of neurocysticercosis. Symptomatic clinical manifestations range from recurrent seizures, focal neurological deficits, increased ICP, cognitive decline, and ocular symptoms.

In the US, the case fatality rate from neurocystercosis is estimated at 2.2%.