Cerebral cysticercosis: occurrence in the immigrant population

Area of Science:

• Neurology
• Infectious Diseases
• Radiology

Background:

• Cerebral cysticercosis is a parasitic infection of the brain caused by the larval cysts of the tapeworm Taenia solium.
• The disease can present with a wide range of neurological signs and symptoms, making diagnosis challenging.
• While endemic in certain regions, it can occur in non-endemic areas due to contaminated food sources.

Purpose of the Study:

• To review diagnosed cases of cerebral cysticercosis at the Neurological Institute of New York.
• To highlight the variability in clinical presentation and diagnostic approaches.
• To discuss current diagnostic and therapeutic strategies for cerebral cysticercosis.

Main Methods:

• Review of six cases diagnosed over 18 years, with detailed analysis of three recent cases.
• Evaluation of conventional radiography (plain films, pneumography) and computerized tomography (CT) for diagnosis.
• Assessment of cerebrospinal fluid (CSF) and serum eosinophilia, and indirect hemagglutination titers.

Main Results:

• Cerebral cysticercosis diagnosis requires a high index of suspicion, especially in immigrants from endemic areas.
• Computerized tomography (CT) and conventional radiography are the most effective diagnostic imaging techniques.
• CSF and serum eosinophilia, along with indirect hemagglutination titers, are nonspecific but can be supportive.

Conclusions:

• Early diagnosis of cerebral cysticercosis is crucial, often necessitating advanced imaging like CT scans.
• Treatment strategies include surgical excision of lesions when feasible and symptomatic management.
• Awareness of potential exposure routes, including contaminated food, is vital even in non-endemic regions.