Helminthic Infections of the Central Nervous System

Tracey A. Cho, MD, FAAN Neuroinfectious Disease p. 1489-1511 October 2018, Vol.24, No.5 doi: 10.1212/CON.0000000000000646
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PURPOSE OF REVIEW: This article discusses select helminthic parasitic infections that may affect the central nervous system and reviews the epidemiology, neurologic presentation, recommended diagnostic testing, and treatment approach to these infections.

RECENT FINDINGS: Emigration from and travel to areas endemic for helminthic infections that affect the nervous system has led to increased incidence of parasitic neurologic disease in developed countries, necessitating that neurologists be familiar with the diagnostic and therapeutic approach to these diseases. Evidence is emerging on the optimal treatment for neurocysticercosis, which varies based on the form of the disease in the nervous system.

SUMMARY: Parenchymal neurocysticercosis is a leading cause of acquired epilepsy worldwide, and extraparenchymal neurocysticercosis is responsible for many cases of hydrocephalus. Recognition of the different stages and locations of neurocysticercosis is essential for proper management. Similarly, schistosomiasis constitutes a major cause of myelopathy in endemic areas and requires prompt diagnosis and treatment to avoid permanent deficits.

Address correspondence to Dr Tracey A. Cho, University of Iowa Hospitals and Clinics, Neurology Department, 200 Hawkins Dr, Iowa City, IA 52242, tracey-cho@uiowa.edu.

RELATIONSHIP DISCLOSURE: Dr Cho has received personal compensation as a consultant for Optum, Inc.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Cho discusses the unlabeled/investigational use of immunomodulatory medications including corticosteroids and oral steroid-sparing agents for the management of inflammation in neurocysticercosis and neuroschistosomiasis.

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© 2018 American Academy of Neurology