Garcia et al have provided consensus guidelines for managing a patient with neurocysticercosis. The spectrum of therapy can range from none at all to aggressive drug therapy over a prolonged period to surgical resections.
Groups of neurocysticercosis:
(1) parenchymal (within the brain)
(2) extraparenchymal
(3) spinal
(4) ophthalmic
Types of parenchymal cysts:
(1) viable (live)
(2) degenerating (enhancing on CT)
(3) calcified (dead)
|
Infection Burden in Parenchymal Infection |
Grade |
|
1 – 5 cysts |
mild |
|
6 – 100 cysts |
moderate |
|
> 100 cysts |
heavy |
|
Parenchymal |
Recommended Therapy |
|
viable cysts, mild |
antiparasitic therapy with steroids |
|
viable cysts, ,moderate |
antiparasitic therapy with steroids |
|
viable cysts, heavy |
antiparasitic therapy with high-dose steroids |
|
degenerating cysts, mild to moderate |
antiparasitic treatment; addition of steroids if side effects develop |
|
degenerating cysts, heavy |
no antiparasitic therapy; high dose steroids and osmotic diuretics |
|
calcified (any number) |
no antiparasitic therapy |
|
Extraparenchymal |
Recommended Therapy |
|
ventricular |
surgical removal if possible; ventricular shunt; antiparasitic therapy with steroids |
|
subarachnoid |
antiparasitic therapy with steroids, ventricular shunt if hydrocephalus |
|
hydrocephalus without cysts |
ventricular shunt; no antiparasitic therapy |
where:
• Subarachnoid cysticercosis includes giant cysts, racemose cysticercosis and chronic meningitis.
• Basal subarachnoid cysticercosis has a poor prognosis and requires prolonged therapy.
|
Other Forms |
Recommended Therapy |
|
spinal cysticercosis (intra-or extra-medullary |
surgical resection |
|
ophthalmic cysticercosis |
surgical resection |
Specialty: Infectious Diseases
ICD-10: ,
