Neurocysticercosis--5 years' experience at the Clinic for Infectious Diseases

Abstract

Neurocysticercosis (NCC) is the most common parasitic disease with wide distribution which is caused by larval forms of Taenia Solium. Our aim was to: show the most common clinical manifestations of patients with NCC and their importance in diagnosing this disease; examine the value of serologic diagnostic methods in blood and cerebrospinal fluid; to emphasize the value of radiological diagnostic methods--CT and MRI of the brain, in relation to the applied protocol of therapy, as well as the impact of anti-parasitic therapy on the outcome of this disease. 13 patients with NCC (from 35 to 63 years of age, median age 49; 61.5% male and 38.5% female) were treated at the Clinic of Infectious Diseases in Novi Sad during a five-year period. Two patients had a positive epidemic data of parasitic diseases of the intestinal tract in childhood. The most common clinical manifestation was headache in 61.5% of patients, and generalized convulsions and hemiparesis in 46.2%. Meningeal inflammation was present in 27.3% of patients. Two of five patients had positive ELISA test for cysticercosis in the serum and cerebrospinal fluid. CT and MRI findings confirmed parenchimal form of NCC in 30.8% of patients, while calcifications were found in 69.2% of patients. All patients were treated with Albendazole, 800 mg a day, in two doses, 30.76% of patients had a favorable outcome of the disease, 53.7% of patients were discharged with complications, and one patient died. The most common manifestation of NCC in our patients was headache, followed by general convulsions and hemiparesis. Radiological diagnostic methods--CT and MRI--proved to be most valuable both in diagnostics and follow-up of lesions. All our patients were treated with Albendazole; Dexamethasone was applied in patients with severe inflammatory reaction, and anti-convulsive drugs in patients with convulsions.