Cysticercosis of the central nervous system.

Abstract

The incidence of cysticercosis of the central nervous system is closely related to the socio-eeonomic development of the nations; in São Paulo (Brazil) the mean frequency in the neurologic out-patients service reaches 0.5%. The author stresses the similarity between basilar racemose cysticercosis and cenurosis. The routes of infestation of the nervous system by the cysticerci, and the reactions they elicit, are analyzed. The author classifies the clinicai forms as hypertensive, convulsive, and forms with prevailing focai neurologic manifestations; these latter, when associated with signs of intracranial hypertension, are called pseudo tumoral forms.
Cerebrospinal fluid changes (presence of eosinophile cells, and positive complement fixation test for cysticercosis) are particularly focused. In 86.5% cf 296 cases examined in the Department of Neurology of the University of São Paulo Medicai School the diagnosis of neurocysticercosis was based on these data. The skull roentgenograms showed micronodular calcifications in 19.9% of cases. The value of neuro-radiologic examinations for settling the pathogenesis of the hypertensive forms is emphasized.
Seldom neurocysticercosis shows spontaneous remission; in the subacute
or chronic forms, conservative treatment (sulfa drugs and corticosteroids) yields satisfactory results; in the hypertensive forms it is necessary, sometimes, to resort to neurosurgical therapy. The prognosis is still unfavorable. The general mortality rate reached 24.7%. The problem of neurocysticercosis claims for a prophylactic solution: the infestation of the swine herds must be the first target; as refers to man, Public Health campaigns must be instituted, aiming at the prevention of teniasis.