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Neurocysticercosis: Report of fifteen cases
M Buitrago1, B Edwards, F Rosner
1Department of Medicine, Queens Hospital Center, Mount Sinai School of Medicine, New York, NY 11432, USA.
Background:
Neurocysticercosis (NCC), which is caused by the encysted larvae of the porcine tapeworm Taenia solium, is uncommon in developed countries.
Methods:
Fifteen cases were reviewed retrospectively from the medical records of patients admitted to Queens Hospital Center, a 550-bed acute care municipal hospital in New York City, from 1986 through 1992. All patients were immigrants from Central and South America. Nine were men and six were women; age range was 11-80 years, mean 33.8 years. Thirteen of the 15 patients (86%) were admitted with seizures. One patient had a strokelike syndrome with transient slurred speech and confusion.
Results:
Diagnosis was based on clinical findings, CT or MRI studies (100%), and ELISA titers (81%). Cerebrospinal fluid abnormalities were noted in 5 of 7 samples obtained. Twelve adult patients with NCC were treated with praziquantel and steroids, and their courses were uncomplicated, except for one patient who required ventricular shunt placement for hydrocephalus.
Conclusions:
NCC should be suspected in immigrants from Central and South America who have seizures; it may complicate the differential diagnosis of various central nervous system syndromes. Available therapies entail risks and uncertainties. The ultimate approach is prevention of infestation.