ABSTRACT
@#Neurocysticercosis is an infection of the central nervous system (CNS) by larval stage of Taenia solium (pork tapeworms) called cysticerci. Humans may acquire the infection through ingestion of T. solium embryonated eggs after consuming contaminated undercooked food or water. Being a multiracial country where pig farming is limited and consumption of raw or undercooked food is an uncommon practice, the prevalence of neurocysticercosis in Malaysia is presumably low. However, through immigration and international travel, cases of neurocysticercosis may go underreported. Due to unfamiliarity with the disease, cases of neurocysticercosis also may be missed in Malaysia. Therefore, thorough history taking and physical examinations with high index of suspicion are required by the clinicians to warrant proper investigations in order to meet the diagnosis of neurocysticercosis. Patients diagnosed with neurocysticercosis should be treated cautiously with anthelmintic, to avoid unwanted overwhelming immunological response that can lead to unfavourable outcomes. This is a case report of a foreign worker who presented with first onset of focal seizure associated with intermittent headache.
ABSTRACT
Neurocysticercosis(NCC) is an important disease in central nervous system caused by infectionwith <i>Taenia solium </i>metacestodes. Inaddition to clinical findings and the imaging analysis, the results ofimmunological tests are informative to diagnose NCC. To compare the usefulnessof serum and cerebrospinal fluid (CSF) samples for antibody detection test,paired serum and CSF samples from NCC and other neurological disease patientswere examined by an enzyme-linked immunosorbent assay with low-molecular-weightantigens purified from <i>T. solium</i> cystfluid in a blinded fashion. Sensitivities of both serum and CSF samples were25.0% in inactive NCC cases (n = 4) and 90.9% in active NCC cases (n = 33) and specificitiesof serum and CSF were 100% and 95.8%, respectively. By the combination of serumand CSF samples, sensitivity for active NCC cases became 100%. There was nodifference in the test performance between serum and CSF samples. Based onthese results, we suggest the detection of specific antibodies in serum for thediagnosis of active NCC because of an easy collection of it. However, in caseof the antibody test negative, CSF should be used to confirm NCC and to ruleout other medical disorders of central nerve system. For diagnosis of suspectedinactive NCC cases, antibody detection test using either serum or CSF has alimited diagnostic value and cannot be recommended.
ABSTRACT
Neurocysticercosis (NCC) is an important disease of the central nervous system caused by infection with <i>Taenia solium</i> metacestodes. In addition to the clinical findings and the imaging analysis, the results of immunological tests are informative for the diagnosis of NCC. To compare the usefulness of serum and cerebrospinal fluid (CSF) samples for antibody detection, paired serum and CSF samples from patients with NCC and other neurological diseases were examined by an enzyme-linked immunosorbent assay with low-molecular-weight antigens purified from <i>T. solium</i> cyst fluid in a blinded fashion. The sensitivity of both serum and CSF samples was 25.0% in inactive NCC cases (n = 4) and 90.9% in active NCC cases (n = 33), and the specificity of serum and CSF was 100% and 95.8%, respectively. When the serum and CSF samples were combined, the sensitivity in active NCC cases became 100%. There was no difference in test performance between serum and CSF samples. Based on these results, we recommend the detection of specific antibodies in serum for the diagnosis of active NCC because of the ease of collection. When the antibody test is negative, however, CSF should be used to confirm NCC and to rule out other medical disorders of the central nervous system. Antibody detection test using only serum or CSF has a limited diagnostic value and cannot be recommended for the diagnosis of suspected inactive NCC cases.