Neurocysticercosis

Neurocysticercosis is a parasitic infection of your brain and spinal cord caused by the pork tapeworm (Taenia solium). You can get this infection by swallowing tapeworm eggs, often from contaminated food, water or surfaces.

Once inside your body, the eggs hatch. The larvae (baby parasites) travel through your bloodstream and can reach your brain. There, they form cysts. These are fluid-filled sacs that hold the parasite.

These cysts can press on important parts of your brain. This pressure can cause seizures, long-lasting headaches or other serious symptoms

It might be scary to think about parasites in your brain. But there are treatments that can kill the parasites or remove problematic cysts so you can feel better.

Neurocysticercosis symptoms

Symptoms depend on how many cysts are in your brain and where they are. Sometimes, there are no symptoms at all. Other times, symptoms are very bothersome or even serious. They may include:

• Difficulty speaking
• Dizziness
• Headaches
• Muscle weakness
• Seizures
• Trouble with thinking, memory or concentration

Seizures are the most common symptom.

Neurocysticercosis causes

Ingesting eggs of the pork tapeworm, Taenia solium, causes neurocysticercosis. Tapeworms are tiny parasites. Eating pork doesn’t directly cause brain cysts. But it’s part of the process. Symptoms may not appear until months or even years after the initial infection. Here’s how it works:

1. A person with an adult pork tapeworm (from eating contaminated pork) passes tapeworm eggs in their poop.
2. They don’t wash their hands after they poop. Then they touch food or other nearby surfaces.
3. You accidentally eat contaminated food with the eggs on it.
4. Inside your intestine, the eggs hatch into larvae (baby tapeworms).
5. The larvae travel through your blood and lodge in places like your brain, muscles or eyes.
6. Cysts (fluid-filled sacs containing parasites) form where the larvae land.

Risk factors of neurocysticercosis

You’re more likely to get this infection if you:

• Are around someone who has the infection or carries a tapeworm
• Don’t have access to clean water
• Don’t have safe or reliable sanitation
• Live near pigs that can eat human waste
• Touch contaminated surfaces or objects without washing your hands properly

Where is neurocysticercosis most common?

This infection is most common in rural areas of Asia, Africa and Latin America. The risk is higher in places where people raise pigs, and the pigs can eat human waste.

Complications of neurocysticercosis

A severe and life-threatening complication of this infection is intracranial hypertension. This is when you have increased pressure inside of your skull. Visit the emergency room or call 911 if you notice sudden vision changes, severe headaches, and nausea and vomiting.

If this infection doesn’t get treatment right away, you may be at risk of continued seizures after the infection clears. This long-term complication happens because calcified bits (scar-like spots) can stay even after the infection goes away.

How doctors diagnose neurocysticercosis

A healthcare provider will start with a physical exam. They’ll also use imaging tests, like a CT scan or MRI, to look for cysts in your brain or spinal cord. These tests show where the cysts are and how many there may be.

Blood tests can support the diagnosis, but imaging is the main way doctors confirm it. Rarely, a lumbar puncture or brain biopsy may be needed in atypical cases.

Your provider may also recommend other tests, like an eye exam, to check if cysts affect other parts of your body.

Neurocysticercosis treatment

Treatment is different for each person. It depends on your symptoms, how many cysts you have and where they are. Treatment may include:

• Killing parasites: Antiparasitic medicines destroy the parasites in your body.
• Reducing inflammation: When cysts die, they can cause swelling. Your provider may give you anti-inflammatory medicine (like corticosteroids) along with antiparasitic treatment.
• Managing symptoms: Medicines can help with seizures, headaches or pressure inside your skull.
• Surgery: In severe cases, surgery may help if a cyst blocks fluid in your brain or causes other severe problems.

Sometimes, parasites die on their own. In those cases, you may not need antiparasitic medicine.

Your healthcare provider will decide the best treatment for you and explain how it can help.

When should I see my healthcare provider?

See a healthcare provider right away if you think you might have this infection. It’s especially important if you live near pigs or have been in an endemic area where this infection is common

If you have a seizure for the first time, call 911 (or your local emergency services number) or go to the emergency room immediately.

Neurocysticercosis prognosis

The outlook is different for each person. Parasites can be unpredictable. And it’s hard to know exactly what they’ll do once they’re in your body.

Your body’s immune status can affect how the parasite impacts you. People with weaker immune systems may face more acute (sudden) complications. Getting treatment quickly gives you the best chance for recovery.

You might start to feel better within a few weeks of treatment and not have any long-term issues. But in some severe cases, the infection may clear while seizures or other complications stay.

Your healthcare provider may prescribe long-term antiseizure medicine, especially if calcifications (scar-like spots) remain.

Can neurocysticercosis be prevented?

Most cases can be prevented with good hygiene and sanitation. Here are some ways to lower your risk:

• Wash your hands: Use soap and water after using the toilet, caring for animals and before preparing food.
• Practice safe food and water habits: Drink safe water, wash fruits and vegetables before eating and keep food prep areas clean.
• Treat carriers: If someone has taeniasis (an adult tapeworm infection), they should get treatment. This prevents them from shedding eggs that can infect others. Antiparasitic medicine is available for people. Pigs are dewormed or vaccinated.
• Use a toilet: Avoid going to the bathroom outdoors. Animals can eat human waste, which helps parasites spread.