Journal of Neuroinfectious Diseases
Open Access

Neurocysticercosis is a parasitic infection that specifically targets the brain and central nervous system (CNS). This condition is caused by the larvae of a tapeworm known as Taenia solium, which is commonly found in pigs. Humans can acquire the infection by consuming food or water contaminated with the eggs of the tapeworm [1]. The life cycle of the Taenia solium tapeworm involves two main hosts: humans and pigs. When a human ingests undercooked pork containing cysticerci (the larval stage of the tapeworm), the cysticerci release thousands of eggs in the intestines. These eggs then pass out of the human host through feces, contaminating the surrounding environment. If the eggs are ingested by pigs, they hatch in the pig’s intestines and develop into larvae. These larvae can penetrate the intestinal wall and migrate to various tissues in the pig’s body, forming cysts [2]. The lifecycle continues as humans consume raw or undercooked pork infected with these cysts. However, in the case of neurocysticercosis, if a human accidentally ingests the eggs instead of the cysts, a different pathway occurs. Once the eggs are ingested, they hatch in the human intestines, releasing the larvae. The larvae then enter the bloodstream, allowing them to travel to different tissues throughout the body, including the brain and CNS. When the larvae reach the brain, they can lodge themselves within the neural tissue and develop into fluid-filled cysts known as neurocysticerci [3,4]. These cysts can vary in size and number and have the potential to cause a range of neurological symptoms and complications. The cysts’ location within the brain and the extent of inflammation they generate determine the specific symptoms experienced by the infected individual. The presence of neurocysticerci in the brain can lead to various neurological manifestations [5]. Common symptoms include frequent headaches, seizures, neurological deficits (such as muscle weakness or paralysis), cognitive impairment, visual disturbances, and alterations in behavior or mood. The severity and progression of these symptoms can vary depending on the number, size, and location of the cysts. In some cases, neurocysticercosis can result in severe complications. For instance, the presence of multiple cysts in the brain can cause inflammation and obstruct the flow of cerebrospinal fluid, leading to a condition called hydrocephalus. If a cyst ruptures or triggers an immune response, it can cause inflammation and swelling in the surrounding brain tissue, potentially leading to stroke or other severe neurological consequences [6].

Diagnosing neurocysticercosis can be challenging due to its diverse clinical presentations and resemblance to other neurological disorders. However, various diagnostic tools are employed to detect the presence of cysts in the brain. Imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) scans are commonly utilized to identify the cysts and determine their number, size, and location. In some cases, a blood test called an enzyme-linked immunoelectrotransfer blot (EITB) may be conducted to detect specific antibodies against the tapeworm. However, the accuracy of this test can be influenced by factors such as the stage of infection and the immune response of the individual [7]. Treatment of neurocysticercosis typically involves a combination of medication and, in certain situations, surgical intervention. Anti-parasitic drugs such as albendazole or praziquantel are administered to kill the cysts and reduce inflammation. These medications are often accompanied by corticosteroids to control inflammation and swelling in the brain. The duration and dosage of the treatment depend on the severity of the infection and the individual patient’s condition. Surgical intervention may be necessary in cases where the cysts cause significant symptoms, obstruct normal brain function, or result in complications such as hydrocephalus. The surgical procedures aim to remove the cysts or alleviate any blockages caused by the cysts, thus relieving pressure within the brain. Prevention of neurocysticercosis involves implementing proper hygiene practices and public health measures. It is crucial to ensure thorough cooking of pork to kill any potential tapeworm larvae. Maintaining proper sanitation and hygiene, such as washing hands before handling food and consuming clean water, is essential. Public health education programs play a significant role in raising awareness about the risks of tapeworm infections, promoting good sanitation practices, and preventing the spread of the disease. While neurocysticercosis is more prevalent in regions with poor sanitation and limited access to clean water, it can also occur in individuals who have traveled to or migrated from endemic regions. If you suspect you may have neurocysticercosis or have concerns about the infection, it is crucial to seek medical attention and consult with a healthcare professional for an accurate diagnosis and appropriate management. The symptoms of neurocysticercosis can vary depending on the number, size, and location of the cysts in the brain. The presence of cysts can lead to various neurological manifestations and complications. Here are some common symptoms associated with neurocysticercosis:

Headaches: Headaches are a common symptom and can range from mild to severe. They may be frequent and persistent, often resembling migraines.

Seizures: Seizures are a prominent symptom of neurocysticercosis and can take various forms, including generalized tonic-clonic seizures (convulsions), focal seizures (involving specific body parts or functions), or complex partial seizures (alterations in consciousness and behavior).

Neurological deficits: Neurocysticercosis can cause neurological deficits, such as muscle weakness, sensory disturbances, coordination difficulties, or problems with balance and gait. These deficits depend on the location of the cysts within the brain and the extent of inflammation they induce.

Cognitive impairment: In some cases, neurocysticercosis can lead to cognitive impairment and difficulties with memory, attention, concentration, and overall cognitive function. This can significantly affect daily functioning and overall quality of life.

Visual disturbances: Cysts located near the optic nerve or visual processing areas of the brain can result in visual disturbances. These may include blurred vision, double vision, visual field defects, or even vision loss.

Changes in behavior: Neurocysticercosis can cause alterations in behavior, personality, and mood. These changes can manifest as irritability, aggression, depression, anxiety, or psychosis.

In severe cases, neurocysticercosis can lead to more serious complications:

Hydrocephalus: Hydrocephalus is the accumulation of cerebrospinal fluid (CSF) within the brain, resulting in increased pressure. Cysts located in certain areas of the brain, such as the ventricles or pathways through which CSF flows, can obstruct the normal circulation and absorption of CSF, leading to hydrocephalus.

Stroke: Neurocysticercosis can increase the risk of stroke, particularly if a cyst ruptures or causes inflammation in the blood vessels of the brain. This can lead to the interruption of blood flow to specific areas, resulting in stroke-like symptoms such as weakness, numbness, or difficulty speaking.

Intracranial hypertension: In some cases, neurocysticercosis can lead to increased intracranial pressure, which can cause severe headaches, vomiting, altered consciousness, and potentially lifethreatening complications. Diagnosing neurocysticercosis can be challenging because its symptoms can resemble other neurological conditions. A comprehensive evaluation is necessary to establish a proper diagnosis. Common diagnostic approaches include:

Imaging studies: Imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) scans are commonly employed to detect the presence of cysts in the brain. These imaging modalities can provide detailed information about the number, size, and location of the cysts, aiding in diagnosis and treatment planning.

Blood tests: In some cases, a blood test may be conducted to detect specific antibodies against the tapeworm. The presence of these antibodies indicates exposure to the parasite and can support the diagnosis. However, blood tests may have limitations in terms of sensitivity and specificity, depending on the stage of the infection and the individual’s immune response [8]. It is crucial to consult with a healthcare professional if neurocysticercosis is suspected. They can evaluate the symptoms, conduct appropriate diagnostic tests, and determine the most suitable treatment approach. Treatment for neurocysticercosis typically involves a combination of medication and, in some cases, surgical intervention. Anti-parasitic drugs such as albendazole or praziquantel are used to kill the cysts and reduce inflammation. Corticosteroids may also be prescribed to help control inflammation and swelling in the brain. Surgical removal of the cysts may be necessary in certain cases, especially if they are causing significant symptoms or complications [9,10]. Prevention of neurocysticercosis involves good hygiene practices, such as thorough cooking of pork to kill any potential tapeworm larvae, maintaining proper sanitation, and avoiding the consumption of contaminated food or water. Public health measures, including education about the risks and proper sanitation practices, are important for preventing the spread of this infection. It’s worth noting that while neurocysticercosis is more common in regions with poor sanitation and limited access to clean water, it can occur in other parts of the world as well, particularly in individuals who have traveled to or migrated from endemic regions. If you suspect you may have neurocysticercosis or have any concerns, it’s essential to consult with a healthcare professional for an accurate diagnosis and appropriate management.

Conclusion

Neurocysticercosis is a parasitic infection that affects the brain and central nervous system. It is caused by the larvae of the Taenia solium tapeworm, which is typically found in pigs. Human infection occurs through the ingestion of food or water contaminated with tapeworm eggs. The symptoms of neurocysticercosis can vary depending on the number and location of the cysts in the brain. Common manifestations include headaches, seizures, neurological deficits, cognitive impairment, visual disturbances, and changes in behavior. In severe cases, it can lead to complications such as hydrocephalus, stroke, or even death.

Acknowledgement

Not applicable.

Conflict of Interest

Author declares no conflict of interest.

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