Racemose Neurocysticercosis

Abstract

Neurocysticercosis is one of the most common infections of the central nervous system in the developing world. Most often, neurocysticerci are found in the brain parenchyma, at the gray-white matter junction. A rare form of neurocysticercosis is the development of cysts at the basal subarachnoid region, termed racemose neurocysticercosis.

Racemose neurocysticercosis

“…Infection is typically characterized by the presence of intraparenchymal cysts within the cerebral hemispheres at the gray-white junction and NCC is the most frequent cause of acquired epilepsy in the developing countries. [ 17 ] Parasitic infestation is endemic to South and Central America, Southeast Asia, China, and Sub-Saharan Africa[ 6 ] and is of increasing importance in the United States due to high volumes of immigration from these endemic areas. [ 6 14 24 ] Extraparenchymal NCC is less common than the intraparenchymal form and is defined as NCC involving the subarachnoid, meningeal, and intraventricular space.…”

“…[ 17 ] Parasitic infestation is endemic to South and Central America, Southeast Asia, China, and Sub-Saharan Africa[ 6 ] and is of increasing importance in the United States due to high volumes of immigration from these endemic areas. [ 6 14 24 ] Extraparenchymal NCC is less common than the intraparenchymal form and is defined as NCC involving the subarachnoid, meningeal, and intraventricular space. Extraparenchymal NCC presents unique diagnostic and therapeutic challenges compared to the intraparenchymal form.…”

“…The variant is characterized by the presence of multilobulated confluent cysts within the basal subarachnoid space that appear “grape-like” both radiographically and pathologically. [ 6 ] In this report, we describe the successful management of a patient with extensive racemose NCC and hydrocephalus treated with cerebrospinal fluid (CSF) diversion and prolonged administration of albendazole and corticosteroids with complete radiographic and clinical resolution of infection.…”

Racemose cysticercosis: A summary of 5 reported Thai cases

“…[ 3 ] One is “isolated cyst” (cysticercus cellulosae) and the other is “racemose cyst (cysticercus racemosus).”[ 1 ] The racemose cysticercosis is a specific extremely rare form of neurocysticercosis that the parasitic cysts are usually detected at the basal subarachnoid region. [ 4 ] The appearance of racemose cysticercosis looks like “a collection of transient membranes forming a cluster like a bunch of grapes.”[ 3 ] Less than 80 reports are documented in PubMed. In this short article, the authors report a summary on previous publications on Thai patients with racemose cysticercosis.…”

Commentary

“…In addition, it is the main cause of adult-onset epilepsy in endemic areas. [ 2 3 ] NCC is a relatively common infection in developing countries. Additionally, due to immigration and traveling in recent decades, physicians in westerns countries have been faced with incidental cases of NCC.…”