Chapter 71 - Neurocysticercosis

Summary

Neurocysticercosis (NCC) is a major contributor to the burden of seizures in the world, and is also one of the few preventable causes of seizures and epilepsy. Infection is caused by ingestion of the eggs of the tapeworm, excreted with the feces of an infected human tapeworm carrier. The majority of cysticercosis cases are in older children and young adults, presenting as a single degenerating intraparenchymal lesion. Another particular clinical setting associated with seizures is the occurrence of perilesional edema around a dead, calcified parasite. The primary diagnostic approach when neurocysticercosis is suspected is the use of brain imaging. The differential diagnosis of a single brain enhancing lesion is problematic. Treatment of epilepsy secondary to NCC follows standard guidelines for the management of any other secondary epilepsies. Neurocysticercosis is rarely associated with refractory seizures, and first-line antiepileptic drugs (AEDs) usually achieve good seizure control.