Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru.
Clin Microbiol Rev. 2020 May 27;33(3). doi: 10.1128/CMR.00085-19. Print 2020 Jun 17.
neurocysticercosis (NCC) is endemic in most of the world and contributes significantly to the burden of epilepsy and other neurological morbidity. Also present in developed countries because of immigration and travel, NCC is one of few diseases targeted for eradication. This paper reviews all aspects of its life cycle (taeniasis, porcine cysticercosis, human cysticercosis), with a focus on recent advances in its diagnosis, management, and control. Diagnosis of taeniasis is limited by poor availability of immunological or molecular assays. Diagnosis of NCC rests on neuroimaging findings, supported by serological assays. The treatment of NCC should be approached in the context of the particular type of infection (intra- or extraparenchymal; number, location, and stage of lesions) and has evolved toward combined symptomatic and antiparasitic management, with particular attention to modulating inflammation. Research on NCC and particularly the use of recently available genome data and animal models of infection should help to elucidate mechanisms of brain inflammation, damage, and epileptogenesis.
神经囊尾蚴病(NCC)在世界上大多数地区流行,是癫痫和其他神经疾病发病率高的重要原因。由于移民和旅行,NCC 在发达国家也存在,是少数几种被定为要消灭的疾病之一。本文综述了其生命周期的各个方面(带绦虫病、猪囊尾蚴病、人脑囊尾蚴病),重点介绍了其诊断、治疗和控制方面的最新进展。带绦虫病的诊断受到免疫或分子检测方法的限制。NCC 的诊断取决于神经影像学检查结果,辅助血清学检测。NCC 的治疗应根据具体的感染类型(脑实质内或脑实质外;病变数量、位置和阶段)进行,已逐渐向联合对症和驱虫治疗发展,特别注意调节炎症。对 NCC 的研究,特别是对最近可用的基因组数据和感染动物模型的使用,应该有助于阐明脑炎症、损伤和癫痫发生的机制。