Neurocysticercosis (NCC) is one of the most common parasitic diseases of the nervous system and also the main cause of acquired epilepsy. It is a major public health problem in developing countries.
NCC occurs due to accidental ingestion of tapeworm eggs through undercooked food or water contaminated with tapeworm eggs or through poor hygiene practices.
Tapeworm has two host biological cycles. Human is the definite host carrying adult tapeworm in intestines and pigs as intermediate host harbouring larvae or cysticercus. Human having tapeworm in their intestines excrete millions of eggs which are ingested by pigs. Larvae from eggs cross into circulation and deposit into the central nervous system (CNS), muscles, eyes and subcutaneous tissue of pigs as cysticercus. Now when this poorly cooked meat is ingested by human beings, these larvae (cysticercus) develop into an adult tapeworm in human intestines. When the eggs of tapeworm are ingested accidentally by human beings instead of pigs NCC develops in human beings.
Symptoms occur according to sites of cysticercus. The most common symptom is epilepsy is the most common site of cysticercosis is CNS. NCC may also cause headache, hydrocephalus, stroke and neuropsychiatric disturbance.
Radio imaging is now available easily and this is the reason for increased diagnosis of Neurocysticercosis nowadays. Nodules(cysticercus) can also be found subcutaneously and under the tongue. Epilepsy along with biopsy can give indirect evidence of Neurocysticercosis in absence of radio imaging.
Cysticercus usually die after some time in the brain and other sites but in the initial stages, it may cause some swelling in the brain which may give rise to epilepsy. The main goal of treatment is to control epilepsy in NCC. Usually, anti-epileptic drugs are given for 2 to 5 years. After this recurrence is rare but in some cases, anti-epileptic drugs have to be given lifelong.
Neurocysticercosis can be prevented by maintaining good hygiene and eating properly cooked meat. Government authorities should ensure a clean water supply and implement good hygienic conditions at restaurants and roadside food vendors.
