Cerebral cysticercosis

Abstract

Cerebral cysticercosis is the result of infestation of the brain with the larval stage of the intestinal tape worm Taenia Solium. The disease, endemic in some parts of the world, especially Mexico, South America, India, Eastern Europe, is still encountered practically all over the world. There appear to be distinct geographical variations not only in the incidence but also the pattern of the disease. The commonly accepted modes of infection do not stand a critical analysis of available epidemiological data. The brain is a site of predilection for this infestation, where it results in meningeal racemose, parenchymatous ventricular or mixed types of lesions. It may thus produce meningo-encephalitis, granulomatous meningitis, ependymitis, focal granulomas, solitary or multiple parenchymatous cysts, hydrocephalus or a combination of these. Clinically its manifestations are protean and often perplexing, consisting, either alone or in combination, of raised intracranial pressure, focal or multifocal or generalized epileptic seizures, signs and symptoms of a focal mass lesion, hydrocephalus or chronic meningo-encephalitis. Important features of the disease are remissions and recurrences. Laboratory diagnostic investigations are generally unrewarding, there being so far, no single completely reliable test. Recent CAT scan studies have been helpful but not always diagnostic. There is no known medical treatment. Excision of a solitary parenchymatous or intraventricular lesion provides gratifying results but the management of diffuse lesions, presenting with raised intracranial pressure ("pseudo-tumour") is often frustrating. Extensive bilateral decompression, with or without an additional thecoperitoneal shunt, is helpful in some of these cases.