Severe Cysticercal Meningitis: Clinical and Imaging Characteristics

Cárdenas, Graciela; Jung, Helgi; Rı́os, Camilo; Fleury, Agnès; Soto-Hernández, José Luís

doi:10.4269/ajtmh.2010.09-0347

Cited by 27 publications

(20 citation statements)

References 26 publications

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“…In some cases the cause of the meningitis may be unclear because no identifying features such as vesicular membranous structures are present. [53]…”

Section: Symptomatic Diseasementioning

confidence: 99%

Diagnosis and treatment of neurocysticercosis

Nash

Garcı́a²

2011

Nat Rev Neurol

213

201

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Neurocysticercosis, a major cause of acquired seizures and epiilepsy, is caused by infection with the larval cystic form of the tapeworm, Taenia solium. CT and MRI imaging, development of sensitive and specific diagnostic methods, and discovery of relatively effective anti-cestode drugs, revolutionized knowledge of the burden of infection and disease and led to effective treatments. Here we review the rationale of treatment, the essential role of inflammation in the genesis of disease and its exacerbation as a result of anti-parasitic treatment, and limitations in the efficacy of current anti-parasitic and anti-inflammatory treatments. The importance of “end stage” calcified granulomas as foci of seizures and epilepsy with and without perilesional edema in endemic populations has recently been recognized. New information indicates perilesional inflammation around some calcified foci is associated with seizures and perilesional edema, which suggests that anti-inflammatory treatments may play a role in controlling or preventing epilepsy in these patients. Most importantly, neurocysticercosis is one of the few diseases that can be eradicated, an accomplishment that would prevent millions of cases of epilepsy.

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“…In some cases the cause of the meningitis may be unclear because no identifying features such as vesicular membranous structures are present. [53]…”

Section: Symptomatic Diseasementioning

confidence: 99%

Diagnosis and treatment of neurocysticercosis

Nash

Garcı́a²

2011

Nat Rev Neurol

213

201

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“…Actually, previous reports have shown a widely variable occurrence of meningeal signs, from 44 to 80% [24–26]. …”

Section: Discussionmentioning

confidence: 99%

Clinical Symptoms, Imaging Features and Cyst Distribution in the Cerebrospinal Fluid Compartments in Patients with Extraparenchymal Neurocysticercosis

et al. 2016

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Extraparenchymal neurocysticercosis has an aggressive course because cysts in the cerebrospinal fluid compartments induce acute inflammatory reactions. The relationships between symptoms, imaging findings, lesion type and location remain poorly understood. In this retrospective clinical records-based study, we describe the clinical symptoms, magnetic resonance imaging features, and cyst distribution in the CSF compartments of 36 patients with extraparenchymal neurocysticercosis. Patients were recruited between 1995 and 2010 and median follow up was 38 months. During all the follow up time we found that 75% (27/36) of the patients had symptoms related to raised intracranial pressure sometime, 72.2% (26/36) cysticercotic meningitis, 61.1% (22/36) seizures, and 50.0% (18/36) headaches unrelated to intracranial pressure. Regarding lesion types, 77.8% (28/36) of patients presented with grape-like cysts, 22.2% (8/36) giant cysts, and 61.1% (22/36) contrast-enhancing lesions. Hydrocephalus occurred in 72.2% (26/36) of patients during the follow-up period. All patients had cysts in the subarachnoid space and 41.7% (15/36) had at least one cyst in some ventricle. Cysts were predominantly located in the posterior fossa (31 patients) and supratentorial basal cisterns (19 patients). The fourth ventricle was the main compromised ventricle (10 patients). Spinal cysts were more frequent than previously reported (11.1%, 4/36). Our findings are useful for both diagnosis and treatment selection in patients with neurocysticercosis.

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“…However, extensive and comprehensive revision of the diagnostic criteria of NCC, especially of extraparenchymal NCC, is mandatory according to many recent publications [5,7,10]. …”

Section: Discussionmentioning

confidence: 99%

Extraparenchymal neurocysticercosis in the United States: a case report

Kelesidis

Tsiodras

2011

J Med Case Reports

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IntroductionNeurocysticercosis is endemic in the developing world, but is becoming more common in the United States due to immigration.Case presentationA 26-year-old Caucasian man presented with headache, nausea and vomiting and was found to have hydrocephalus and meningitis. Brain imaging and immunological studies were suggestive of neurocysticercosis. Endoscopic removal of the cyst resulted in resolution of symptoms. This case represents a combination of two rare presentations of extraparenchymal neurocysticercosis; intraventricular neurocysticercosis and subarachnoid neurocysticercosis.ConclusionAlthough neurocysticercosis is pleomorphic in its presentation, extraparenchymal neurocysticercosis may be challenging to diagnose and treat. Clinicians should be aware of this condition given increasing incidence in the United States.

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Severe Cysticercal Meningitis: Clinical and Imaging Characteristics

Cited by 27 publications

References 26 publications

Diagnosis and treatment of neurocysticercosis

Diagnosis and treatment of neurocysticercosis

Clinical Symptoms, Imaging Features and Cyst Distribution in the Cerebrospinal Fluid Compartments in Patients with Extraparenchymal Neurocysticercosis

Extraparenchymal neurocysticercosis in the United States: a case report

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