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3.6.4

Neurocysticercosis

Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 3, Central Nervous System Conditions.

Clinical Description

  • Parasitic infection caused by larval cysts of the pork tape worm Taenia Solium

Signs and Symptoms

  • Asymptomatic
  • Seizures
  • Focal neurological deficits
  • Features of raised intracranial pressure

Investigations

  • CT or MRI brain

Pharmacological

  • Albendazole 7.5mg/kg twice daily for 8 days
  • Drug-induced damage to cyst cerci may precipitate an acute inflammatory reaction, the intensity of which is related to the number of viable cysts and may cause cerebral oedema. This reaction is minimized by adding corticosteroids to the anthelminthic treatment,
  • Prednisone 1-2mg/kg daily for 8 days.
  • Treat seizures according to seizure protocol

Non-pharmacological

  • Neurosurgical intervention if patient has hydrocephalus
  • Neuroprotective measures

Complications

  • Seizures
  • Hydrocephalus
  • Developmental regression

Refer all post-op patients for intensive medical rehabilitation Services.

Complications and Referral Criteria

All patients should be referred for neuroimaging

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