All of the following are true of Neurocysticercosis EXCEPT
Correct Answer: More common in vegetarians
Description: (B) More common in vegetarians # NEUROCYSTICERCOSIS (NCC) is caused by the CNS infection with the pork tapeworm Taenia solium, which is endenic in most low-income countries where pigs are raised.> Perpetuation of this parasitic disease is related to poor sanitation and hygiene.> Clinical presentation: There is a variable time interval between the point of infection and the onset of symptoms (ranging from 1-30 years).> Clinical presentation includes: Seizures: most common symptom and most common cause of seizures in young adults in endemic areas 2 Headaches, Hydrocephalus, Altered mental status, Neurological deficits> CSF serology may be helpful with the initial diagnosis especially in cases of intraventricular/subarachnoid infection.> Pathology: Infection causes extra-intestinal disease (Neurocysticercosis) usually occurs as a result of eating food or drinking water contaminated by human faeces containing T. solium eggs.> This is distinct from the 'normal' life cycle in which the under cooked pork is eaten and the larval cysts contained within, mature into adult intestinal tapeworm.> Extra-intestinal infection changes to specific clinical & imaging occurs progression in four stages of infection.# Escobar's pathological stages:> There are four main stages: Vesicular: Viable parasite with intact membrane and therefore no host reaction. Colloidal vesicular: Parasite dies within 4-5 years 1 untreated, or earlier with treatment and the cyst fluid becomes turbid. As the membrane becomes leaky oedema surrounds the cyst. This is the most symptomatic stage. Granular Nodular: Oedema decreases as the cyst retracts further; enhancement persists. Nodular calcified: End-stage quiescent calcified cyst remnant; no oedema.> Location: Infection can be both intra and extra axial. Subarachnoid space over the cerebral hemispheres (can be very large): most commonly located parenchyma. Second most common location is seen near grey matter (frequently seen}-white matter junction basal cisterns may be "grape like" (racemose): most lack an identifiable scolex ventricles usually solitary cysts 4th ventricle most frequent Typically the parenchymal cysts are small (1cm) whereas the subarachnoid cysts can be much bigger (up to 9 cm): differential therefore being arachnoid cyst. It is the most common cause of epilepsy in endemic areas (Southeast Asia, South America) with progression through the four stages taking anywhere between 1 to 9 years.
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