Managing neurocysticercosis: challenges and solutions

Taenia solium neurocysticercosis (NCC) is a major cause of neurological morbidity in the world. Variability in the neuropathology and clinical presentation of NCC often make it difficult to diagnose and manage. Diagnosis of NCC can be challenging especially in endemic and resource-limited countries...

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Bibliographic Details
Published in:International Journal of General Medicine 2015-01, Vol.8 (default), p.333-344
Main Authors: Fogang, Yannick Fogoum, Savadogo, Abdoul Aziz, Camara, Massaman, Toffa, Dènahin Hinnoutondji, Basse, Anna, Sow, Adjaratou Djeynabou, Ndiaye, Mouhamadou Mansour
Format: Article
Language:English
Subjects:
Antigens
Care and treatment
Convulsions & seizures
Cysticercosis
Developing countries
Diagnosis
Disease control
Emergency medical care
Epidemiology
Epilepsy
Feces
Hypertension
Infections
LDCs
Medical imaging
Medical research
Medicine, Experimental
Methods
Mortality
Nervous system
Parasites
Population
Public health administration
Review
Worms
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Summary:Taenia solium neurocysticercosis (NCC) is a major cause of neurological morbidity in the world. Variability in the neuropathology and clinical presentation of NCC often make it difficult to diagnose and manage. Diagnosis of NCC can be challenging especially in endemic and resource-limited countries where laboratory and imaging techniques are often lacking. NCC management can also be challenging as current treatment options are limited and involve symptomatic agents, antiparasitic agents, or surgery. Although antiparasitic treatment probably reduces the number of active lesions and long-term seizure frequency, its efficacy is limited and strategies to improve treatment regimens are warranted. Treatment decisions should be individualized in relation to the type of NCC. Initial measures should focus on symptomatic management, with antiparasitic therapy only to be considered later on, when appropriate. Symptomatic treatment remains the cornerstone in NCC management which should not only focuses on epilepsy, but also on other manifestations that cause considerable burden (recurrent headaches, cognitive decline). Accurate patients' categorization, better antiparasitic regimens, and definition of new clinical outcomes for trials on NCC could improve management quality and prognosis of NCC. Prevention strategies targeting tapeworm carriers and infected pigs are yielding good results in local models. If local elimination of transmission is confirmed and replicated, this will open the door to cysticercosis eradication efforts worldwide.
ISSN:1178-7074
1178-7074
DOI:10.2147/IJGM.S73249