bubble_chart Overview

The disease caused by the larvae of Taenia solium, known as Chinese Taxillus Herb, in the brain, meninges, or ventricles, leading to corresponding neurological dysfunction, is called cerebral cysticercosis, accounting for over 80% of cysticercosis cases. The incidence is relatively high in regions such as North China, Northeast China, and Northwest China.

bubble_chart Diagnosis

1. History and Symptoms:

There is often a history of consuming measly pork or food contaminated with tapeworm segments. Depending on the number and location of cysticerci invading the nervous tissue, inflammatory reactions and toxic stimulation symptoms may occur. Based on clinical manifestations, it can be classified into the following types:

1. Meningoencephalitis type: More common, often caused by a single massive infection leading to diffuse cerebral edema and reactive inflammation, with clinical manifestations of psychiatric symptoms.

2. Epileptic type: Cysticerci are located in the cortical motor area, with epileptic seizures as the prominent symptom, which can manifest as grand mal, petit mal, or psychomotor seizures.

3. High intracranial pressure type: Cysticerci in the ventricular system obstruct cerebrospinal fluid circulation, leading to clinical symptoms such as headache, vomiting, blurred vision, and other signs of high intracranial pressure.

2. Physical Examination Findings:

Depending on the clinical type, different signs may be observed during physical examination.

1. Subcutaneous nodules: Most patients may have palpable, firm, round or oval subcutaneous nodules measuring 0.5–1.5 cm, which are freely movable and non-tender. Biopsy can confirm the diagnosis.

2. Focal signs: Due to surrounding inflammatory reactions, cysticerci in the brain parenchyma may cause corresponding focal neurological deficits, such as monoplegia, hemiplegia, ataxia, positive pyramidal tract signs, or positive meningeal irritation signs. In the high intracranial pressure type, papilledema and decreased vision may be observed.

3. Auxiliary Examinations:

1. Blood and cerebrospinal fluid tests: Eosinophilia may be present.

2. Positive cysticercus complement fixation test.

3. Stool examination may reveal tapeworm eggs or segments.

4. Lumbar puncture may show increased intracranial pressure, with elevated cerebrospinal fluid cytology and protein levels.

5. Head CT or MRI may reveal multiple scattered intracranial lesions, often confirming the diagnosis.

bubble_chart Treatment Measures

1. For the treatment of intestinal tapeworm, take 50-90g of cushaw seed kernel powder on an empty stomach. Two hours later, take a decoction of Areca Seed (80g of Areca Seed slices boiled in 500ml of water until reduced to 150-200ml). After another half hour, take 50-60ml of 50% magnesium sulfate. The worm body is usually expelled within three hours.

2. Praziquantel: Administer at a total dose of 120-180mg/kg, divided over five or seven days. A second course of treatment may be conducted after one month.

3. Symptomatic treatment: For those with epileptic seizures, use antiepileptic drugs (refer to the epilepsy section). For increased intracranial pressure, administer dehydration therapy to reduce pressure. For obstructive hydrocephalus, a ventriculoatrial or ventriculoperitoneal shunt may be performed.