The American Academy of Neurology (AAN) has released an evidence-based guideline on treating neurocysticercosis, a tapeworm infection causing seizures that is common in developing countries and is now on the rise in developed countries, including the United States. The guideline is published in the April 9, 2013, print issue of Neurology®, the medical journal of the American Academy of Neurology.
"It is critical for neurologists and other health care providers to recognize this infection," said guideline lead author Karen L. Roos, MD, of Indiana University School of Medicine in Indianapolis and a Fellow of the American Academy of Neurology. "This previously rare disease in the United States is increasingly prevalent, and the infection and epilepsy due to the infection are preventable."
Neurocysticercosis is an infection of the brain or spinal cord caused by the tapeworm Taenia solium. The tapeworm can also cause taeniasis, an infection of the intestines. If the infection spreads to the brain or spinal cord, it can cause seizures, swelling of the brain and other symptoms. About two million people worldwide have epilepsy from this tapeworm, which, according to the World Health Organization, is the most common preventable epilepsy in the developing world.
The guideline, which was developed by reviewing all available evidence, determined that a combination of the drug albendazole and a corticosteroid can effectively treat neurocysticercosis. Albendazole is used to kill the parasite. Either dexamethasone or prednisolone is used to treat the inflammation that develops as the parasite is dying.
The tapeworm Taenia solium can infect people in two ways. The infection of the intestines happens when a person eats raw or undercooked meat that has the tapeworm cysts in it. A person gets neurocysticercosis by eating food or drinking water contaminated with the tapeworm eggs. Food can be contaminated with fecal matter from a person who has the infection. Usually, this happens from poor hygiene within a household or other environment.
Infection from this tapeworm is preventable. Good personal hygiene is critical to prevent the transmission of infection from person to person. This involves washing hands thoroughly after using the bathroom.
The guideline is endorsed by the American Epilepsy Society.
- R. A. Baird, S. Wiebe, J. R. Zunt, J. J. Halperin, G. Gronseth, K. L. Roos. Evidence-based guideline: Treatment of parenchymal neurocysticercosis: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 2013; 80 (15): 1424 DOI: 10.1212/WNL.0b013e31828c2f3e
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