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NEUROCYSTICERCOSIS CAN CAUSE SEIZURES YEARS LATER
THIS NEWSLETTER IS FOR INFORMATIONAL PURPOSES ONLY. NOTHING IN THIS CONTENT CONSTITUTES MEDICAL, PSYCHOLOGICAL, OR PROFESSIONAL ADVICE. ALWAYS CONSULT A QUALIFIED HEALTHCARE PROFESSIONAL BEFORE MAKING ANY HEALTH RELATED DECISIONS.
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OKAY BACK FROM THE EPILEPSY CLINIC 🩺
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A FIRST SEIZURE DURING A NAP ⚡
A 31 Year Old Man Came To An Emergency Department After A Seizure
He Had No Significant Past Medical History
It Was His First Seizure
He Was Taking A Nap When It Happened
A Family Member Noticed His Arms And Legs Shaking
The Shaking Lasted Three Minutes
Afterward He Was Lethargic And Confused
He Reported No Fever Or Weakness
A CT Scan Found A Cystic Lesion In His Left Frontal Lobe
It Measured 3 By 2 Centimeters And Was Partly Calcified
An MRI Showed A Cystic Mass With Two Lobes
Cancer Was Suspected At First
Surgeons Opened His Skull And Removed The Lesion For Testing
The Pathology Showed No Cancer
It Confirmed Cysticercosis Instead
That Means Larvae Of The Pork Tapeworm Had Invaded His Brain
His Blood Also Tested Positive For Cysticercus Antibodies
The Cysts Were Calcified And His Eyes Were Not Involved
So Antiparasitic Treatment Was Put Off
He Was Sent Home On A Seizure Medicine
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THREE MEN WITH REPEATED SEIZURES 🩻
Three Men From Northwest Vietnam Were Admitted To Hospital In 2018
All Three Had A History Of Recurrent Seizures
One Had Been Having Them For Three Years
Another Had Been Having Them For Four Days
The Third Had Been Having Them For Seven Years
Headaches Affected Two Of The Men
One Also Had Occasional Nausea
Two Had Already Been Treated With Seizure Drugs
Their Seizures Were Not Well Controlled
None Had Signs Of Cognitive Decline
All Three Tested Positive For Antibodies To Cysticercosis
Brain MRI Revealed Several Cysts With Clearly Defined Borders
The Scans Showed The Larva's Head Inside The Cysts
Doctors Concluded The Cysts Were The Cause Of Their Epilepsy
They Were Treated With Antiparasitic And Steroid Drugs
No Brain Surgery Was Done
Checks Up To A Year After Discharge Found All Three Seizure Free
Cysticercosis Is Endemic To Vietnam
Few Studies Have Measured How Common It Is There
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HOW A BRAIN CYST DIES ⏳
Symptoms Can Start Months To Years After Infection
They Begin As The Cysts Degenerate
That Can Cause Focal Or Generalized Seizures
Each Cyst Starts Out Alive
A Living Cyst Has A Clear Membrane And Clear Fluid
The Larva's Head Is Folded Inside It
Living Cysts Cause Little Inflammation Around Them
An Attack By The Immune System Can Make A Cyst Degenerate
The First Stage Of Degeneration Is Called The Colloidal Stage
Its Fluid Turns Cloudy And The Head Starts Breaking Down
Brain Tissue Around It Shows Swelling And Damage
On Scans The Cyst Wall Looks Thicker
Next The Head Turns Into Mineral Granules
By Then The Parasite Is No Longer Alive
Finally What Is Left Becomes A Calcified Nodule
Patients With Calcified Cysts May Keep Having Seizures For Years
This Can Happen Even In Patients Deemed Cured
Worldwide Neurocysticercosis Is A Leading Cause Of Acquired Epilepsy
WHO Estimates It Causes 30 Percent Of Epilepsy Cases
That Figure Applies Where The Pork Tapeworm Is Common
