Earnest M P, Reller L B, Filley C M, Grek A J
Department of Medicine, University of Colorado School of Medicine, Denver.
Rev Infect Dis. 1987 Sep-Oct;9(5):961-79. doi: 10.1093/clinids/9.5.961.
Neurocysticercosis has become more prominent in the United States in recent years because of an increase in immigration from endemic regions and because of improved ease of diagnosis with computed tomography (CT). Neurocysticercosis should be suspected in any patient from a high-risk region who has symptoms or signs of a central nervous system disorder, especially seizures, headaches, or signs of increased intracranial pressure. The best diagnostic test is CT of the head, which usually shows a combination of multiple punctate calcifications; hydrocephalus; and parenchymal, subarachnoid, or intraventricular cysts with and without contrast enhancement. Cysticercosis is confirmed serologically by measurement of cysticercosis antibody titers in serum or cerebrospinal fluid and histologically by biopsy of a lesion. Treatment with praziquantel and dexamethasone is usually sufficient, but ventricular shunting or surgical removal of intraventricular or spinal cysts may be necessary. Whenever a case is identified, other household members should be examined for symptoms and signs of neurocysticercosis and screened for active Taenia solium infection.
近年来，由于来自流行地区的移民增加以及计算机断层扫描（CT）诊断便利性的提高，神经囊尾蚴病在美国变得更加突出。对于任何来自高危地区且有中枢神经系统疾病症状或体征的患者，尤其是癫痫发作、头痛或颅内压升高的体征，都应怀疑患有神经囊尾蚴病。最佳诊断检查是头部CT，通常显示多种点状钙化、脑积水以及实质、蛛网膜下腔或脑室内囊肿的组合，有或无对比增强。囊尾蚴病通过检测血清或脑脊液中的囊尾蚴病抗体滴度进行血清学确诊，并通过病变活检进行组织学确诊。通常使用吡喹酮和地塞米松治疗就足够了，但可能需要进行脑室分流或手术切除脑室内或脊髓囊肿。一旦确诊病例，应对其他家庭成员进行神经囊尾蚴病症状和体征检查，并筛查活动性猪带绦虫感染。
