Neurocysticercosis

NEUROCYSTICERCOSIS By Dr. Sheelendra Shakya Dept. of Paediatrics, KMCTH

INTRODUCTION ,[object Object],[object Object]

TYPES OF CYSTS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MODE OF INFECTION ,[object Object],[object Object]

MODE OF INFECTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TARGET TISSUES ,[object Object],[object Object]

PRESENTATION ,[object Object],[object Object],[object Object],[object Object],[object Object]

CLASSIFICATIONS ,[object Object],[object Object],[object Object],[object Object]

Anatomical Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],Nelson

CLINICAL PRESENTATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CLINICAL PRESENTATION ,[object Object],[object Object],[object Object],[object Object],[object Object]

CLINICAL PRESENTATION ,[object Object],[object Object],[object Object]

CLINICAL PRESENTATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sotelo et al classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Carpio et al ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Chorobski Classification CSF diversion procedure Basal meningeal or ventricular cysticercus giving rise to hydrocephalus and intracranial HTN, rarely focal signs and mental disturbances Group III Exeresis rarely useful but may be undertaken in life-threatening conditions Diffuse cerebral syndrome due to numerous cysticerci leading to cerebral oedema, intracranial HTN, organic brain syndrome Group II Exeresis often indicated Space occupying intracranial tumor like behaviour producing focal neurological manifestations and ultimately raised ICP Group I SURGICAL IMPLICATION CLINICAL FEATURES GROUP

INVESTIGATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

RADIOLOGICAL STAGING (A) Viable cyst with scolex

(C) calcified cyst (non-contrast CT)

STAGES OF NC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],D.Sharada et al

DIAGNOSTIC CRITERIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Del Brutto et al

DIAGNOSTIC CRITERIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Del Brutto et al

SUGGESTED DIAGNOSTIC CRITERIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Garg

Tuberculoma Versus Cysticercus Granuloma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Rajshekhar et al Target lesions: Lesions with central nidus of calcification or a dot enhancement

Magnetic Resonance Spectroscopy ,[object Object],[object Object],Cysticercosis working group in Peru

TREATMENT VS NO TREATMENT Understanding a controversy

NATURAL COURSE ,[object Object],[object Object],[object Object],[object Object],[object Object],Vedantam Rajshekhar

TREATMENT ,[object Object],[object Object],[object Object],[object Object],AIIMS

RESULTS AIIMS 33% 13% SEIZURES at 6 mths 32% 10% SEIZURES at 3mths 57% 79% RESOLUTION OF LESION (Complete or partial) CONTROL TREATED PARAMETERS

STEROIDS ,[object Object],[object Object],JULIO SOTELO, M.D., AND OSCAR H. DEL BRUTTO, M.D

NEW PROTOCOLS ,[object Object],[object Object]

Surgery restricted to: ,[object Object],[object Object],[object Object],[object Object],[object Object],Garcia et al

[object Object],[object Object],Current Consensus Guidelines for Treatment of Neurocysticercosis Garcia et al

RESULTS ,[object Object],[object Object],Garcia et al

[object Object],[object Object],randomised controlled study and follow-up of at least 5 years (the longest follow-up period yet for this type of study) for 300 neurocysticercosis patients with more than one lesion Garcia et al

Calcification Vs Natural Resolution ,[object Object],[object Object],Garcia et al

RECOMMENDATIONS ,[object Object],[object Object],Garcia et al

[object Object],[object Object],Garcia et al

CONCLUSION ,[object Object],[object Object],[object Object],Garcia et al

REFERENCES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Neurocysticercosis

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