Neurocysticercosis

neurocysticercosis

1. Neurocysticercosis - Ankit Kumar

2. Content Introduction Types of NCC Cause of NCC Habitat of Taenia solium Host of Taenia solium Infective stage Lifecycle of Taenia solium Sign & symptoms Diagnosis Lab diagnosis of NCC Treatment Complication Prevention of NCC Parenchymal Subarachnoid Interventricular Spinal Occular Cysticerocosis Definitive host Intermediate host

3. Introduction It is a tapeworm infection that affect the brain , muscle and other tissues. It is a form of cysticerocosis and is the most common worm infection of the CNS.

4. TYPES

5. Parenchymal It may be associated with headaches, seizures, behavioral changes and hydrocephalus. Impairment of the ability to co-ordinate voluntary movements and muscular weakness on one side of the body (hemiparesis) with occur in form of NCC (Neurocysticercosis).

6. Subarachnoid It is associated with chronic inflammation of the membranes covering the brain (meninges), headaches, seizures and hydrocephalus.

7. Interventricular It may cause obstructive hydrocephalus. This form of cysticerocosis is known as race nose cysticerocosis. Accumulation of cyst at the base of brain potentially resulting in mental deterioration, coma and life –threatening complication. race nose cysticerocosis

8. Spinal It is rare in case but may result in meningitis or compression of the spinal cord.

9. Occular cysticerocosis Occurs when cyst form in eyes. It may include eye pain, loss of vision and separation of the nerve-rich membrane lining the eyes(retina).

10. Cause of NCC Most common cause – Pork tape worm Taenia solium. Consuming under cooked food Particular pork or water contaminated with tapeworm eggs. Poor hygiene practices. Habitat of Taenia Solium They lie in the small intestine of human commonly in jejunum.

11. Host of Taenia solium Taenia solium passes in life cycle in two host- Definitive host – Man Intermediate host – Pig Definitive host:- Human are definitive host and harbours the adult worm. Intermediate host :- Pig are the intermediate host and harbours the larval stage of the worm.

12. Human are infected by consuming in adequately cooked pork containing Cysticircus cellulosae . Man harbouring adult worm leads to auto infection either by unhygienic personal habit or by unhygienic parasitic movement in intestine. Infective stage Cysticircus cellulose ( larval)

13. Lifecycle When Taenia leads to Cysticircus the life cycle is definitive host and intermediate host. The infective stage is egg not larvae. the further development of the eggs in similar man and pigs. The oncosphere are release in the duodenum, jejunum and penetrates the intestinal wall. Enters the lymphatic and carried in systemic circulation to the different parts of the body. They are filtered out principally in the muscles when the develop into larval stage ( Cysticircus cellulosae) in 60-70 days. In human it is a dead end and the larvae die without further development.

14. Sign & symptoms Abdominal pain Nausea/ vomiting Headache Lump Seizures swelling of optic disc Stroke Involuntary movement

15. Diagnosis Lab diagnosis Stool Examination Microscopic examination of faeces show characterized eggs of Taenia in 20-80% of pts. Formal either sedimentation method of stool concentration is useful Egg can also be detected by cellophane swab method (N/4 swab) in 85-95%pts. Proglottids Species identification is possible. Serodiagnosis ELISA, THA 4. Molecular diagnosis Done by DNA probe and PCR.

16. Lab diagnosis of NCC Biopsy :- Definitive diagnosis of cysticerocosis is by biopsy of the lesion and its microscopic examination to show the invaginated, scolex with suckers and hookey. Serology :- ELISA # ELITB ( Enzyme linked-immuno telectro transfer blot) Imaging method :- CT & MRI shows the morphology and localization of cysts, burden of infection, stage of cysts and presence of surrounding.

17. NCC

18. Treatment Paraziquantel and niclosamide are used. A single dose of 2.0gm ( 4tab of 500mg) of niclosamide is effective against adult man. Albendazole or Paraziquantel is used. Surgery may be necessary in select cases of cysticerocosis. # Surgical removal of CNS cysts or placement of a brain shunt( to relieve pressure).

19. Complication Seizure Stroke Vision change Cognitive problems Death

20. Prevention of NCC Public education regarding the parasite and its route of transmission. Avoidance of raw or undercooked pork in endemic areas to avoid intestinal infection. Avoidance of potential fecal- oral routes of transmission through routine hand washing, good personal hygiene as well as proper handling and preparation of foods. Improved sanitary measures for human waste disposal in endemic areas. screening contacts of infected individuals and appropriate treatment. Developing a vaccine for the prevention of NCC which may be used in future. No vaccine are available.