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PubMed1992

The course of seizures after treatment for cerebral cysticercosis.

BACKGROUND: Worldwide, cerebral cysticercosis is one of the most common causes of seizure disorders. Modern cysticidal drugs can usually eliminate the parasite from the brain, but there have been doubts as to whether such treatment improves the seizure disorder. METHODS: We studied 240 patients with seizures and cysticercosis of the brain parenchyma. Of these patients, 118 received cysticidal therapy (albendazole, praziquantel, or both) for lesions without inflammation on imaging studies (group 1); 49 patients with similar lesions either were not offered or refused cysticidal medication (group 2). Another 58 patients with inflammation around cysts (making spontaneous resolution more likely) also did not receive cysticidal medication (group 3), whereas cysticerci were removed surgically in 15 patients (group 4). The 240 patients were followed for a mean (+/- SE) of 92 +/- 7 months. RESULTS: In the patients treated with cysticidal medications, there was an 82 percent reduction in the mean number of brain cysts (from 5.0 to 0.9) and a 95 percent reduction in the mean frequency of seizures (from 11.3 to 0.6 per year; P less than 0.001). After three years of follow-up, 64 patients in group 1 (54 percent) were seizure-free. By contrast, the untreated patients (group 2) averaged 10.9 seizures per year; none were seizure-free. Among those with inflamed cysts (group 3), there was a 74 percent reduction in the frequency of seizures (from 7.5 to 2.7 per year), and 18 patients (31 percent) became seizure-free. After surgical treatment (group 4), there was an 87 percent reduction in the frequency of seizures (from 12.8 to 1.7 per year), and six patients (40 percent) became seizure-free. CONCLUSIONS: After medical treatment of neurocysticercosis, there is usually remission or marked improvement in the associated seizure disorder.

Adult↗
PubMed2006

Assessment of routine inspection methods for porcine cysticercosis in Zambian village pigs.

The value of tongue and meat inspection as diagnostic tools for porcine cysticercosis was assessed in 65 Zambian village pigs by comparing the results with carcass dissections. In addition, the intensity of infections, distribution and viability of cysts in infected pigs were measured. Five pigs (7.7%) were positive on tongue examination, while routine meat inspection showed 12 (18.5%) positives. However, carcass dissections detected cysticerci in 31 (47.7%) pigs. The range in number of cysticerci was 1 to 14,662 per carcass. Cysticerci were distributed throughout the carcass with the highest concentration in the heart, tongue and hind legs. In one animal 13 viable cysts were detected only in the brain. Fourteen pigs had more than 100 viable cysts, six between 2 and 100, and four had single cyst infections. Seven animals harboured only calcified cysts. These findings demonstrate the serious shortcomings of routine detection methods for porcine cysticercosis. While the specificity of tongue palpation and meat inspection was 100%, these tests failed to detect the infection in 83.9% and 61.3% of infected pigs, respectively.

Animals↗
PubMed1977

Cysticercosis of the spine.

A former regular soldier who had served in India before the second World War was in 1953-1955 diagnosed as suffering from cysticercosis affecting the brain and spinal cord as well as the muscles. Twenty years later he was found to have sustained severe damage to the lumbar spine, eventually proved due to cysticercosis involving the bones, joints and psoas muscles. The problem of why and how the disease remained active 40 years after the initial exposure remains unexplained. A search of the literature and enquiries from appropriate specialists have failed to produce any record of a similar case.

Cysticercosis↗
PubMed1987

The value of an antigenic fraction of Cysticercus cellulosae in the serodiagnosis of cysticercosis.

Fractions of Taenia solium cysticerci were isolated using preparative isoelectric focusing. A fraction isoelectric between pH 7.8 and 10.0 was found to be most effective as an antigen in an enzyme-linked immunosorbent assay (ELISA) for anti-cyst antibodies. The efficacy of this fraction and of a total homogenate of the cysticerci to detect cases of neurocysticercosis by ELISA was compared. The partially purified fraction showed a sensitivity of 80% and specificity of 99.5%. The total homogenate had a sensitivity of 75% and a specificity of 99%. Cross-reactions occurred with sera from patients with hydatid disease. In patients with other parasitic infections the specificity of the isolated fraction (3/120) was considerably better than that of the total homogenate (16/120). Cysticercosis in man is caused by infection with the larval stage of the zoonotic pork tapeworm Taenia solium. The disease is largely one of developing countries and is prevalent in Latin America, Eastern Europe, the Far East and large parts of Africa. In the Republic of South Africa the prevalence of cysticercosis has been estimated as 8.5% amongst rural blacks, and in certain high incidence areas over 20%.

Animals↗
PubMed1988

Cerebral cysticercosis. A disease to suspect in recent travelers or immigrants.

The initial assessment of the young adult patient with multiple intracerebral lesions is challenging. The etiologic factors must be categorized as neoplastic, infectious, inflammatory, vascular, and hematologic, among others. Unfortunately, these lesions are not easily accessible for sampling, and all other diagnostic methods must first be exhausted. This case report describes a patient who was brought to an emergency department in New Jersey after her first seizure. The diagnosis was cerebral cysticercosis, an intracerebral parasitic infection that is extremely rare in this area but very common in other areas of the world. As more and more people immigrate to the United States, researchers believe that cerebral cysticercosis will become more common. It is imperative, therefore, for primary care physicians to understand this disease and to consider it in the appropriate setting.

Adult↗
PubMed2005

Optic nerve cysticercosis: case report and review of current management.

The authors present a case of optic nerve cysticercosis in a 32-year-old patient who presented with sudden blurring of vision in the left eye and a transient visual improvement on systemic steroids. The ocular findings were unremarkable other than a relative afferent pupillary defect (RAPD). An ultrasound of the orbit, CT and MRI scans revealed a cystic lesion in the orbital portion of the optic nerve close to the eyeball. A presumed diagnosis of optic nerve cysticercosis was made on the basis of imaging and a positive serum ELISA. The patient improved dramatically on a 4-week therapeutic trial of albendazole and oral steroids. The post-treatment ultrasound and CT scan showed an involution of the cyst with some residual thickening of the optic nerve.

Adult↗
PubMed1984

Cerebral cysticercosis in children in South Africa.

Sixty-one children with cerebral cysticercosis are presented. The commonest clinical manifestation was epilepsy with or without focal signs in 43% of children, followed by the syndrome of raised intracranial pressure in 34% and meningoencephalitis in 13%. The CT scan was positive in 93% of cases and the HAI test in 86% of children so examined. Both were positive in 80%. Skull X-ray revealed evidence of calcification and/or raised intracranial pressure in 60%. Two children died, one each with subacute sclerosing panencephalitis and tuberculous meningitis. Of those who improved on discharge, 43% had epilepsy and 32% neurological deficit of an obvious nature. The parasitology, pathogenesis, pathology and diagnosis of cerebral cysticercosis are briefly reviewed. Present therapy and the suggested use of a specific anti-cysticeral drug are discussed. Case histories are presented to draw attention to the variability of the clinical picture and the particular importance of recognising the acute parenchymatous form of the disease in children which may present with critically elevated intracranial pressure.

Adolescent↗
PubMed2002

A positive enzyme-linked immunoelectrotransfer blot assay result for a patient without evidence of cysticercosis.

The enzyme-linked immunoelectrotransfer blot (EITB) has been considered diagnostic of cysticercosis when the results are positive. We describe a patient with a single band at 50 kDa on EITB and neuroimaging abnormalities suggestive of neurocysticercosis but no evidence of exposure to Taenium solium. Autopsy findings excluded neurocysticercosis. We suggest that a single band at 50 kDa on an EITB be considered an equivocal finding rather than diagnostic of cysticercosis.

Adult↗
PubMed1991

Clinical evaluation of the cysticercosis enzyme-linked immunoelectrotransfer blot in patients with neurocysticercosis.

During the 3 years that the enzyme-linked immunoelectrotransfer blot (EITB) assay for the diagnosis of human cysticercosis has been in use at the Centers for Disease Control, 50 patients with both pathologically confirmed neurocysticercosis and computed tomographic (CT) or magnetic resonance imaging (MRI) scan results were identified. Of 32 patients with two or more lesions, 94% had detectable antibodies by EITB compared with 28% of 18 patients with single lesions. Patients with only calcified cysts (single or multiple) were less likely to have EITB-positive results than were those with noncalcified, enhancing lesions. Antibody was detectable more frequently in serum than in cerebrospinal fluid, regardless of the number or apparent condition of the cysts. These findings confirm that the EITB assay for cysticercosis antibodies is highly sensitive in patients with multiple, enhancing intracranial lesions but is less sensitive in patients with single lesions and in those with calcified lesions.

Adolescent↗
PubMed2001

Cysticercosis of the triceps--an unusual pseudotumor: case report and review.

Cysticercosis is a disease caused by encysted larvae of the tapeworm Taenia solium. Most muscular disease presents with central nervous system involvement or multiple cysts or both. The authors report a 25-year-old woman with a rare single muscle cyst presenting as a tender hard triceps mass. Results of clinical examination and magnetic resonance imaging were indicative of a soft tissue tumor. Excision of the mass revealed purulence, and the histologic diagnosis was cysticercosis. In the differential diagnosis of isolated muscular masses, a rare isolated cysticercus presenting as a pseudotumor should be considered.

Adult↗
PubMedDate not supplied

CT myelography in spinal cysticercosis.

Four cases of spinal cysticercosis were found in a series of 356 cases of CNS cysticercosis studied neuroradiologically. Cysticercal cysts were seen to migrate within the spinal subarachnoid space on myelographic studies. All four patients presented initially with hydrocephalus, which supports the notion that spinal leptomeningeal cysts have migrated from an intracranial site of origin. Computed tomographic myelography (metrizamide) allowed better localization and definition of the spinal cysticercal lesions.

Adult↗
PubMedDate not supplied

MR imaging of intraventricular cysticercosis.

Three cases of cysticercosis with cysts located in the cerebral ventricles were studied with magnetic resonance (MR) imaging. This technique proved to be diagnostically superior to CT. In fact, MR can effectively replace metrizamide CT ventriculography in the detection of intraventricular cysticercosis.

Adult↗
PubMed2004

Disseminated cysticercosis with pulmonary involvement.

Cysticercosis is an important public health problem in developing countries. The central nervous system is the major site of involvement, although striated muscles and subcutaneous tissue are frequently involved in the disseminated form of disease. We describe a recent case in which pulmonary nodules due to cysticercosis were detected on CT and MRI.

Albendazole↗
PubMed2000

Subcutaneous cysticercosis involving the eyelid: sonographic diagnosis.

A 25-year-old man and a 14-year-old boy presented with neurocutaneous cysticercosis involving the eyelid. Both patients had hundreds of scattered subcutaneous cysticerci. They were arranged in clusters over the sternocleidomastoid muscle in the neck. Such clustering of cysticerci is highly suggestive of central nervous system (CNS) involvement, as both the sternocleidomastoid muscle and the CNS are supplied by the carotid artery and cysticerci travel via the hematogenous route. We used ultrasonography to diagnose subcutaneous cysticercosis, which showed characteristic low reflective cysts and high reflective scolices inside. Although subcutaneous cysticerci are inconsequential, their verification is important in the diagnosis of more severe CNS involvement. They may be confused with other painless swellings such as lymphadenopathies, neurofibromas, and epidermoid cysts.

Adolescent↗
PubMed1990

Cysticercosis: cellular immune responses during primary and secondary infection.

Immune reactions to cysticercosis have been extensively studied in mice. The lack of significant lymphocyte infiltration into the livers of infected mice and the obvious role of antibodies in rejection has led to the general conclusion that cellular reactions do not play a role in protection against this disease. In contrast, the present study examining the immune response to cestode infections in a large animal model (sheep) revealed the presence of a massive and highly organized cellular infiltration in the livers after a secondary Taenia hydatigena infection. The majority of the infiltrating lymphocytes were of the CD4+ phenotype with much fewer CD8+ cells present. While most gamma delta-TCR+ cells in peripheral blood are SBU-T19+, the majority of gamma delta-TCR+ lymphocytes in the liver lesions are SBU-T19- suggesting selective migration of these cells into the lesions. In contrast to the diffuse distribution of T cells in the lesions, B cells were present as distinct aggregates. In primary T. hydatigena infections, host class I and class II MHC antigens were shown, for the first time in cestode infections, to be absorbed onto the surface of the metacestode bladderwall indicating their possible involvement in parasite survival. No immune reactions were observed close to the parasite although lymphocytes and eosinophils were infiltrating the adjacent portal tract areas. Most lymphocytes in both primary and secondary infections were positive for MHC class II antigens suggesting selective recruitment of activated cells to the site of infection. Significant changes in relative and absolute numbers of lymphocyte subpopulations were also observed in the draining hepatic lymph nodes dominated by a massive increase of B cells. In contrast, at the peak of local cellular infiltration, no changes in lymphocyte subpopulations were observed in peripheral blood showing the limited usefulness of this compartment in studying cellular changes in localized infections. The vigorous cellular response observed in the livers of sheep contrasts sharply with the lack of lymphocyte infiltration reported in mice indicating that small animal models may not be appropriate to study cellular responses to cysticercosis in large animals and man.

Animals↗
PubMed2006

Antibody responses and epitope specificities to the Taenia solium cysticercosis vaccines TSOL18 and TSOL45-1A.

Taenia solium is a cestode parasite that causes cysticercosis in humans and pigs. This study examined the antibody responses in pigs immunized with the TSOL18 and TSOL45-1A recombinant vaccines against T. solium cysticercosis. Immunization with these proteins induced specific, complement-fixing antibodies against the recombinant antigens that are believed to be associated with vaccine-induced protection against T. solium infection. Sera from immunized pigs were used to define the linear B-cell epitopes of TSOL18 and TSOL45-1A. Prominent reactivity was revealed to one linear epitope on TSOL18 and two linear epitopes on TSOL45-1A. These, and oncosphere antigens from other taeniid cestodes, contain a protein sequence motif suggesting that they may show a tertiary structure similar to the fibronectin type III domain (FnIII). Comparison of the location of linear antigenic epitopes in TSOL18 and TSOL45-1A within the proposed FnIII structure to those within related cestode vaccine antigens reveals conservation in the positioning of the epitopes between oncosphere antigens from different taeniid species.

Amino Acid Sequence↗
PubMed1998

Orbital cysticercosis.

BACKGROUND: We report on a case of orbital cysticercosis in a 27-year-old Burmese man who presented with an orbital swelling 7 months after arriving in Australia. METHODS: The presenting history and findings are reviewed and treatment options are discussed. A brief review of the life cycle of the tapeworm Taenia solium is provided. RESULTS: The orbital lesion was successfully treated by surgical excision. CONCLUSION: Cysticercosis should not be forgotten as a possible cause of unusual orbital lesions.

Adult↗