Essay Title: 

Parasites

March 28, 2016 | Author: | Posted in alternative medicine, health and medicine

ABSTRACT

Background

Infection with the larval form of the pork tapeworm , Taenia solium , can lead to the development of cysts in the brain . Surgical removal of cysts has been the accepted treatment for neurocysticercosis characterized by giant cysts when there is associated intracranial hypertension

Methods

We describe 33 patients whom we treated medically for malignant forms of neurocysticercosis . All patients had evidence of intracranial hypertension and subarachnoid cysts at least 50 mm in diameter . All patients received 15 mg of albendazole per kilogram of body weight per day for [banner_entry_middle]

four weeks . Ten patients were also treated with 100 mg of praziquantel per kilogram

per day for four weeks . Seventeen patients received a second course of albendazole , three received a third course , and one received a fourth course . During the first cycle of treatment , all patients also received dexamethasone . Five patients had previously undergone neurosurgery for giant cysts

Results

After a median of 59 months of follow-up (range , 7 to 102 , the condition of all 33 patients had improved , and the cysts had disappeared or become calcified . Of the 22 patients with a history of seizures , only 11 continued to receive antiseizure medications . The median quality-of-life score on the Karnofsky scale improved from 40 to 100 Fifteen patients received a

ventriculoperitoneal shunt because of hydrocephalus

Four patients had persistent sequelae (bilateral partial optic atrophy stroke , or diplopia ) of the cysts

Conclusions

Intensive medical treatment can be effective in patients with neurocysticercosis characterized by giant cysts . Neurosurgery may be required only when there is an imminent risk of death

NUROCYSTICERCOSIS is caused by the larval form of Taenia solium (cysticerci ) and is the most frequent helminthic infection of the central nervous system . 1 ,2 Humans are the definitive hosts for this parasite , and swine are the intermediate hosts . The adult tapeworm

develops in human hosts after they ingest live cysticerci

in undercooked pork . Cysticercosis may develop in both humans and swine that ingest food contaminated with the feces of human carriers of adult cestodes . Adult tapeworms shed proglottids that each contain approximately 60 ,000 eggs . Hence , the most important

risk factor for cysticercosis is the proximity of a tapeworm carrier .3

The clinical picture of neurocysticercosis ranges

from asymptomatic infections to severe , life-threatening

disease .4 Cysticercosis is highly prevalent in developing

countries , where it constitutes a serious public health problem . 3 ,4 Treatment of the severe forms of

neurocysticercosis can be very expensive .5 Among the

forms of the infection , neurocysticercosis characterized

by giant cysts is relatively uncommon ,6 although in

our referral hospital this form accounts for nearly 10

percent of all cases of neurocysticercosis . The subarachnoid space is the most frequent site of neurocysticercosis .6 Neurocysticercosis with giant cysts has generally been defined by the presence of a cyst more than 50 mm in diameter .7 Because of the prognostic and therapeutic implications , we also included in the definition clinical manifestations that suggest an expansile mass and intracranial hypertension Perilesional cerebral edema responds well to corticosteroids , which raises the possibility… [banner_entry_footer]

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