How To Prevent And Treat Neurocysticercosis

Neurocysticercosis occurs when an individual accidentally ingests eggs from a pork tapeworm. The majority of cases happen because food was contaminated by patients with taeniasis. Neurocysticercosis is the most common parasitic illness that affects the nervous system in developing countries. It's also the main factor contributing to acquired epilepsy.

The disease has become increasingly common in the United States, particularly in immigrants from Latin America. In the southwest of the United States, cysticercosis can account for one in ten hospital visits regarding seizures. The disease occurs when larvae form cysts in the brain. Neurocysticercosis is a preventable disease, and there are many treatment methods available for those who are affected.

Ventricular Shunt Placement

For some patients, a ventricular shunt placement may help to treat and manage the symptoms of the disease. A shunt drains extra fluid from the brain. With neurocysticercosis, the cysts in the brain are what cause epilepsy and other neurological symptoms. Cerebrospinal fluid is a cushion that protects the spinal cord and brain. But having too much leads to pressure against the skull and brain. A shunt moves the excess fluid out of a patient's head and moves it to the abdomen. From there, the body absorbs it. This is an important way to lower swelling and pressure in the brain. Not all patients with neurocysticercosis will benefit from a ventricular shunt, but it's an important option to consider.

Antiparasitic Therapy

Antiparasitic therapy is an important component of treating all parasitic diseases, neurocysticercosis included. More than two billion individuals around the world have some kind of parasitic disease. In recent years, there have been a number of advances in antiparasitic treatment options. There have been new therapies to help with malaria, new medications that address intestinal parasites, and expansion of the awareness about parasitic diseases. The use of antiparasitics against cysticercosis has been in play since 1979.

In the past, some physicians questioned whether neurocysticercosis should be treated with antiparasitic medication, since they believed the cysts would drain by themselves. But evidence shows as the cysts degenerate naturally, patients experience more seizures and neurological symptoms. This has led to the scientific conclusion that there are more benefits to using antiparasitic treatments than risks.

Anticonvulsants

Epilepsy and seizures are the most common symptoms of neurocysticercosis. It's important to treat epilepsy to allow patients to function with the greatest possible degree of independence and safety. Anticonvulsants are medications used to help with seizures, regardless of the underlying cause. The exact anticonvulsant medication prescribed will vary depending on a patient's circumstances.

With normal brain function, millions of neurons communicate with each other. They do so by sending electrical signals through their connections. Seizures happen when the electrical impulses are imbalanced, causing the neurons to function abnormally. Antiepileptics work in a few different ways. They alter electrical activity in a patient's neurons, alter the chemical transmission pathways between neurons, or protect the brain's channels from excess electricity.

Anticysticercal Medication

Another important treatment option for neurocysticercosis is anticysticercal medication. This medication helps treat the cysts in the brain. Health professionals will sometimes pair one of these medications with an antiepileptic, so the patient's seizures and cysts are both treated. Two of the most commonly used medications are albendazole and praziquantel, which reduce both the size and number of cysts.

The best treatment for a patient varies, and there have been multiple recorded reactions from patients. There's some evidence this type of medication will cause adverse reactions. As the parasites in the brain die, the body responds with inflammatory signals that can cause further symptoms. Doctors may sometimes prescribe steroids to alleviate the inflammatory response.

Surgical Extirpation

Surgical extirpation is a treatment option for neurocysticercosis that may mitigate some of the adverse effects patients often experience through medication. This option is generally recommended in cases when hydrocephalus occurs. Hydrocephalus is the presence of excess fluid and pressure on the brain. Medical professionals recommend placing a ventricular shunt before removing a cyst. From there, surgically removing the cyst from the brain can help circumvent the inflammatory process.

Since the parasites aren't dying in the brain, there's no reason for the brain to respond with inflammation. Not everyone will benefit from this surgery, and the ideal treatment options depend on the symptom progression. Neurocysticercosis may have remission both with and without treatment. In addition, the symptoms might disappear for a long time, or patients may continue having the same symptoms until their death.