ACTIVE NEUROCYSTICERCOSIS, PARENCHYMAL AND EXTRAPARENCHYMAL - A STUDYOF 38 PATIENTS

In this retrospective study we have analysed a series of 38 patients s een from 1983 to 1992 (mean follow-up, 4.5 years) with active neurocys ticercosis (NCC), 23 (60.5%) with parenchymal and 15 (39.5%) with extr aparenchymal NCC. Classification into these two forms of NCC was based on computed tomography and magnetic resonance imaging criteria. The e nzyme-linked immunosorbent assay performed in cerebrospinal fluid, for anti-Taenia solium antibodies, was positive in 18, of 23 (78%) cases. Epilepsy and/or intracranial hypertension were the most common clinic al presentation (92%). Twenty-three (60.5%) of 38 patients were treate d with praziquantel and/or albendazole. In parenchymal NCC, the effica cy of medical therapy was complete in 13 of 16 (81%) and partial in 3 of 16 (19%) patients. In contrast, in all cases of extraparenchymal NC C treated with cysticidal drugs the results were disappointing. A vent riculoperitoneal shunt was performed in 9 of 13 patients with extrapar enchymal NCC and hydrocephalus. Severe complications, including two de aths, associated with the natural evolution of the disease or with sur gery, occurred only in extraparenchymal NCC. Therefore, we confirm the existence of the two forms of active NCC, parenchymal and extraparenc hymal, which are strikingly different in clinical presentation, medica l therapy response, complications, morbidity and mortality.