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PATHOPHYSIOLOGY OF NEUROCYSTICERCOSIS
Definition: It is a parasitic infection in the central nervous system that is caused by a tapeworm called Taenia solium (T. solium).
Schematic Diagram:
When these eggs are ingested and exposed to gastric acid in the
human stomach, they lose their protective capsule and release a cyst
form called oncosphere (the larva of the tapeworm armed with 4
hooks) and becomes active in the intestinal wall.
The larval cysts penetrate and erodes the intestinal mucosa and
migrate throughout the body via the vascular system to the brain,
muscle, eyes and other structures and lives in tissues as fluid-filled
cysts (metacestodes).
Human Cysticercosis
MRI scan,
Neurocysticerco
CT scan
sis
After entering the CNS, cysticerci are viable and induce slight
inflammatory changes in the surrounding tissues. Minimum inflammatory Sudden
reaction around the cyst because the parasite carry out prostaglandins Headache
and low molecular wieght molecules which decrease perilesional
inflammation and secrete proteases that can degrade interleukin 2 and
immunoglobulin Management:
Corticosteroids
The parasite remains alive and undergo different stages such as vesicular
stage, colloidal stage, granular nodular stage, and nodular calcified
>surgical removal of
Granular stage: the wall of the cyst thickens and scolex is the cyst via endoscopy
transformed into coarse mineralized granules.
Headaches,
vomiting, nausea,
papilledema, Surdical
sleepiness, coma, Excessive accumulation of CSF procedure:
seizures(tonic-clonic within the ventricular spaces of Ventricular
or simple partial or the brain leading to a non- shunt
complex partial communiting hydrocephalus
MRI scan,
CT scan,
EEG
Compression and atrophy of the Small penetrating arteries arising
brain tissues around the dilated from the circle of Willis are also
ocular palsies, ventricles. affected by this inflammatory
altered level of reaction
consciousness, back
Increased intracranial pressure
pain
develops Occlusion of the lumen of the
and papilledema.
vessels and decreased in cerebral
tissue perfusion
Cerebrovascular accident
Neurological impairement
Death