Cysticercosis is the most common parasitic infection affecting the central nervous system. Spinal neurocysticercosis (NCC) is very rare compared with intracranial NCC and requires more aggressive management because these lesions are poorly tolerated. The authors report a case of intradural extramedullary cysticercosis of the entire level of spine with review of the literature.
Central Nervous System ; Cysticercosis ; Neurocysticercosis ; Spine

Neurocysticercosis is an infection of the central nervous system caused by the larval form of the pork tapeworm Taenia solium. In the brain it occurs in two forms: parenchymal and extraparenchymal or racemose cysts. The clinical presentation of racemose cysts is pleomorphic, and is quite different from parenchymal cysticercosis. The clinical diagnosis of racemose cysts is quite challenging, with neuroimaging being the mainstay. However, the advent of newer brain imaging modalities has made a more accurate diagnosis possible. The primary focus of this article is racemose neurocysticercosis and its multitude manifestations, and includes a discussion of the newer diagnostic modalities and treatment options.
Brain ; Central Nervous System ; Cysticercosis ; Diagnosis ; Neurocysticercosis* ; Neuroimaging ; Taenia solium

Background: People were infected with Cysticercus by either eating Taenia solium eggs from the environment or from proglottids in intestines. These eggs hatched to larvae in muscular and cerebral tissue, which causes specific symptoms. \r\n', u'Objectives: To determine symptoms of human cysticercosis. \r\n', u'Subjects and methods: Clinical and para-clinical processes were conducted on 30 cysticercosis patients, of which 21 were male (70%) and 9 female (30%).\r\n', u'Results and conclusion: The main symptoms were headache in 29 patients (96.7%), subcutaneous cysts in 28 patients (93.3%), epilepsy in 14 patients (46.7%), positive ELISA (antigen of T.solium) with samples in 28 (93.3%) and positive ELISA with CSF samples (73.3%), living cysts in the brain were discovered in 25 patients (83.3%) by CT scanner and eosinophylia in 24 patients (80%). Cysticercus nodules were collected from 28 patients in this study; the species were identified by molecular method. A portion of 652 bp of mitochondrial-encoded cytochrome oxidase b (cob) and 217 amino-acid was amplified by Polymerase Chain Reaction (PCR) and sequenced. The nucleotide sequence was comparatively aligned with the known corresponding sequences of Taenia solium Chinese (TsoCN1). Molecular-based analysis revealed that the Cysticercus from the patients in this study was identified as Taenia solium. There is absolute nucleotide and amino-acid similarity between Taenia solium Chinese (hemogeny 99.1-99.8% of nucleotide and 100% of amino acid).\r\n', u'
Cysticercosis ; diagnosis

No abstract available.
Cysticercosis* ; Spine*

PURPOSE: To evaluate MR imaging findings of degenerating parenchymal neurocysticercosis and to determine the characteristics which distinguish it from other brain diseases. METHODS: MR imagings of 19 patients (56 lesions)of degenerating parenchymal neurocysticercosis were retrospectively evaluated, focusing on the size and locationof lesions, signal intensity patterns of cyst fluid and wall, the extent of the surrounding edema and features of contrast enhancement. RESULTS: Degenerating parenchymal neurocysticercosis was located in gray or subcortical white matter in 89.3% of 56 lesions(50/56); most of these (98.2%) were smaller than 2cm in diameter. Cyst fluidsignal was hyperintense relative to CSF on T1 and proton density weighted images (92.9%). A hypointense signal rimof the cyst wall was noted in the lesions on proton density (92.9%) and T2 weighted (98.2%) images. Surrounding edema was mostly mild. Peripheral rim enhancement was noted in all lesions, and this was frequently irregular and lobulated (67.9%) with a focal defect in the enhancing rim (41.1%). CONCLUSION: Findings which could be helpfulin distinguishing degenerating parencymal neurocysticerosis from other brain diseases are as follows : small, superficial lesions ; hyperintense signal of the cyst fluid on T1 and proton density weighted images ; hypointense signal of the cyst wall on proton density and T2 weighted images ; relatively mild extent of surrounding edema,and peripheral rim enhancement which is frequently irregular and lobulated with a focal defect in the enhancingrim.
Brain Diseases ; Cyst Fluid ; Cysticercosis ; Edema ; Humans ; Magnetic Resonance Imaging ; Neurocysticercosis* ; Parasites ; Protons ; Retrospective Studies

OBJECTIVE: The authors report a case of racemose neurocysticercosis presented with myelopathy and hydrocephalus. The cllinical symtoms were not relieved even after the operations with albendazole medication. METHODS: A 44 year-old man was transferred due to headache, quadriparesis and epileptic fit. Preoperative magnetic resonance image(MRI) on brain and computed tomographic cisternogram on brain and upper cervical cord showed racemose cysticercosis on vermis, medulla and upper cervical cord. Two times operations(vesicles removal and adhesiolysis on cerebrospinal fluid pathway) were done with albendazole medication(15mg/kg/day, 30 days). The clinical symtoms were not relieved. Ventriculoperitoneal(V-P) shunt procedure was done and the symtoms were improved. CONCLUSION: The cause of aggravated hydrocephalus might be inflammatory reaction of the host to acute destruction of parasites due to albendazole in the brain.
Adult ; Albendazole ; Brain ; Cerebrospinal Fluid ; Cysticercosis ; Headache ; Humans ; Hydrocephalus* ; Neurocysticercosis* ; Parasites ; Quadriplegia ; Spinal Cord Diseases*

Spinal intradural cysticercosis is a rare manifestation of neurocysticercosis that may present as an isolated lesion. We report a case of sacral intradural cysticercosis misdiagnosed as a metastasis through cerebrospinal fluid seeding in a 48-year-old patient who underwent ependymoma surgery 3 months ago. We performed S1-2 laminectomy with the total removal of intradural lesion. The cysticercosis was confirmed histologically. The patient was given albendazole with corticosteroid.
Albendazole ; Brain Neoplasms* ; Brain* ; Cerebrospinal Fluid ; Cysticercosis* ; Ependymoma ; Humans ; Laminectomy ; Middle Aged ; Neoplasm Metastasis* ; Neurocysticercosis ; Spine

Spinal intradural cysticercosis is a rare manifestation of neurocysticercosis that may present as an isolated lesion. We report a case of sacral intradural cysticercosis misdiagnosed as a metastasis through cerebrospinal fluid seeding in a 48-year-old patient who underwent ependymoma surgery 3 months ago. We performed S1-2 laminectomy with the total removal of intradural lesion. The cysticercosis was confirmed histologically. The patient was given albendazole with corticosteroid.
Albendazole ; Brain Neoplasms* ; Brain* ; Cerebrospinal Fluid ; Cysticercosis* ; Ependymoma ; Humans ; Laminectomy ; Middle Aged ; Neoplasm Metastasis* ; Neurocysticercosis ; Spine

The diagnosis and management of neurocysticercosis have changed after the recent introduction of Enzyme Linked Immuno-sorbent Assay(ELISA) and praziquantel. Authors reviewed 11 cases of surgically proved neurocysticercosis in which these new diagnostic and therapeutic methods were applied. Age was widely distributed(range 16-59, mean 40 yeats old). Male preponderance was noted as in other reports. ELISA was tested in all cases and 10 out of 11 cases were strongly positive, while 1 case of degenerated cysticercosis was negative. Praziquantel was tried but failed in 5 cases before surgical intervention. Removed cysticerci were located in the fourth ventricle(5 cases), the parenchyme(3 cases), the lateral ventricle(1 case), the cistern-parenchyme(1 case), and the cisterna magna(1 case). Conclusions were as followings : ELISA was reliable in the diagnosis, but was deceitful as a quantitative base during follow-up. If progressive hydrocephalus was detected on the follow-up brain CT(computerized tomography) and no improvement was found clinically after praziquantel therapy in the case of positive ELISA and hydrocephalus, authors recommend ventriculography in the case of suspicious intraventricular lesion, or recommend shunting procedure in simple hydrocephalus. If the apparent mass disappeared after praziquantel or surgical intervention in the case of positive ELISA, but no improvement occurred clinically, then authors recommend considering of mixed type cysticercosis and performing the diagnosis work-up.
Brain ; Cysticercosis ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay* ; Follow-Up Studies ; Humans ; Hydrocephalus ; Male ; Neurocysticercosis ; Praziquantel*

Albendazole is a new drug for the treatment of cerebral cysticercosis. We have recently experience a case that had shown poor therapeutic response to praziquantel. The patient have multiple parenchymal cysts. She was treated with 15mg/kg/day of albendazole for 1 month to confirm healing of the intracranial lesion by the follow up brain CT scan and CSF-ELISA associated with marked clinical improvement.
Albendazole* ; Brain ; Cysticercosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Neurocysticercosis* ; Praziquantel ; Tomography, X-Ray Computed