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神经囊虫病管理的最新进展。

Updates on the management of neurocysticercosis.

机构信息

Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA.

Center for Global Health, Universidad Peruana Cayetano Heredia.

出版信息

Curr Opin Infect Dis. 2018 Oct;31(5):377-382. doi: 10.1097/QCO.0000000000000480.

Abstract

PURPOSE OF REVIEW

The goal of this review is highlight recent developments regarding neurocysticercosis, including recently developed guidelines.

RECENT FINDINGS

Recent diagnostic criteria highlight the importance of neuroimaging in establishing a diagnosis. Monoclonal antibody-based antigen detection and the enzyme-linked immunotransfer blot can be confirmatory. Management should be guided by the form of disease. Single enhancing lesions and one to two viable parenchymal cysticerci can be treated with short courses of albendazole and corticosteroid. Multiple parenchymal lesions should be treated with the combination of corticosteroids, albendazole, and praziquantel. Ventricular cysticerci should be removed when possible, often by minimally invasive surgery. Subarachnoid cysticercosis often requires prolonged courses of antiparasitic and anti-inflammatory treatment.

SUMMARY

Neurocysticerocis represents a spectrum of disease that is a common cause of neurologic disease worldwide. Management needs to be guided by the number and location of the parasites and the host response.

摘要

目的综述

本文旨在强调神经囊虫病的最新进展,包括新制定的指南。

最新发现

最近的诊断标准强调了神经影像学在确立诊断中的重要性。基于单克隆抗体的抗原检测和酶联免疫转移印迹试验可作为确证试验。治疗应根据疾病的类型进行指导。单发强化病变和一至两个存活的脑实质囊虫可采用短程阿苯达唑和皮质类固醇治疗。多发脑实质病变应采用皮质类固醇、阿苯达唑和吡喹酮联合治疗。如有可能,应通过微创手术切除脑室囊虫。蛛网膜下腔囊虫病通常需要长期的抗寄生虫和抗炎治疗。

总结

神经囊虫病代表了一种广泛的疾病谱,是全世界常见的神经疾病病因。治疗需要根据寄生虫的数量和位置以及宿主的反应来指导。

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