Cisticercosis del SNC: ¿Cómo debe ser manejado? 2011 - Hugo Garcia (Perú)

Cysticercosis of the central nervous system: how should it be managed?
Curr Opin Infect Dis. 2011 Jul 22. [Epub ahead of print]
Garcia HH, Gonzalez AE, Gilman RH.
aDepartment of Microbiology, Center for Global Health - Tumbes, Universidad Peruana Cayetano Heredia bCysticercosis Unit, Instituto Nacional de Ciencias Neurologicas cDepartment of Veterinary Public Health, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru dDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Abstract
PURPOSE OF REVIEW:
Taenia solium neurocysticercosis (NCC) has been long recognized as an important cause of neurological morbidity in most of the world. Unwarranted generalization of diagnostic and treatment recommendations made it difficult to assess individual prognosis and responses for each type of NCC. Understanding of the main clinical presentations (dependent on number, location, size, and stage of parasites, as well as on the immune response of the host) allows a better view of treatment options and expected outcomes.

RECENT FINDINGS:
Current treatment options are still limited and involve symptomatic agents, antiparasitic agents, or surgery. The importance of adequate symptomatic management, the potential for improved antiparasitic treatment regimes, in particular combination therapy, and the increasingly important role of minimally invasive neurosurgery are also reviewed in this article.

SUMMARY:
Treatment decisions in NCC should be individualized in relation to the type of NCC. Initial measures should focus on the symptomatic management before considering antiparasitic therapy when appropriate. Appropriate patient categorization, new antiparasitic regimes, and minimally invasive surgery are improving the prognosis of patients with NCC.