Neurocysticercosis

Infections by Taenia solium can lead to neurocysticercosis, a paracytic infection of the CNS. T. solium is often ingested when eating undercooked pork containing larval cysts. The larvae grow within the small intestine, then penetrate into the blood stream and can end up anywhere in the body.

Then most common presentation to the emergency department is new onset seizure. A detailed history should include recent travel and known exposures. A CT of the brain with contrast may elicit enhancing ring lesions or localized edema. An MRI may be required for further characterization of the lesions. Further diagnostics, such as serology can be done as an inpatient.

Acute treatment should include seizure prophylaxis, including lorezepam and phenytoin. Praziquantel should be started upon the diagnosis of neurocysticercosis and steroids may or may not be added. However, these treatments should be started as an inpatient.

References:

Marx, JA., et al. Rosen’s Emergency Medicine: Concepts and Clinical Practice, 6th edition. Mosby. 2006.