Download PDF
Semin Neurol 2011; 31(3): 231-244
DOI: 10.1055/s-0031-1287651
© Thieme Medical Publishers

Neurologic Parasitic Infections in Immigrants and Travelers

Kiran Thakur1 , 2 , 3 , Joseph Zunt4
  • 1Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
  • 2Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts
  • 3Harvard Medical School, Boston, Massachusetts
  • 4Departments of Neurology, Global Health, Medicine (Infectious Diseases) and Epidemiology, University of Washington, Harborview Medical Center, Seattle, Washington
Further Information

Publication History

Publication Date:
30 September 2011 (online)

    Permissions and Reprints

ABSTRACT

Infectious diseases are increasingly common in modern clinical practice and the contemporary neurologist must be aware of the clinical manifestations, potential complications, and management of common travel-related infections. The authors provide an approach to patients who present with neurologic symptoms, with a history of travel to or residence in tropical and developing countries. Although many other infections are important in this demographic, they focus on three parasitic infections that neurologists may encounter: cerebral malaria, neuroschistosomiasis, and neurocysticercosis. The epidemiology, pathophysiology, clinical manifestations, diagnostic evaluation, and treatment are discussed for each infection.

KEYWORDS

Neuroinfectious diseases - neuroschistosomiasis - cerebral malaria - neurocysticercosis

REFERENCES

  • 1 Poser C, Poser J. Neurology in the developing world (book review).  Brain. 2006;  129 (6) 1624-1629
    CrossrefPubMedGoogle Scholar
  • 2 Han M H, Zunt J R. Neurologic aspects of infections in international travelers.  Neurologist. 2005;  11 (1) 30-44
    CrossrefPubMedGoogle Scholar
  • 3 Talisuna A O, Bloland P, D'Alessandro U. History, dynamics, and public health importance of malaria parasite resistance.  Clin Microbiol Rev. 2004;  17 (1) 235-254
    CrossrefPubMedGoogle Scholar
  • 4 World Health Organization .World Malaria report 2010. Available at: http://www.who.int/malaria_world_malaria_report_2010/en/index.html Accessed December 14, 2010
    Google Scholar
  • 5 Lou J, Lucas R, Grau G E. Pathogenesis of cerebral malaria: recent experimental data and possible applications for humans.  Clin Microbiol Rev. 2001;  14 (4) 810-820
    CrossrefPubMedGoogle Scholar
  • 6 World Health Organization. Malaria. In: International Travel and Health 2003. Geneva: World Health Organization; 2003
    Google Scholar
  • 7 National Institute of Allergy and Infectious Diseases. The Life Cycle of the Malaria Parasite. Available at: http://www.niaid.nih.gov/topics/malaria/pages/lifecycle.aspx Accessed December 14, 2010
    Google Scholar
  • 8 Idro R, Jenkins N E, Newton C R. Pathogenesis, clinical features, and neurological outcome of cerebral malaria.  Lancet Neurol. 2005;  4 (12) 827-840
    CrossrefPubMedGoogle Scholar
  • 9 Snow R W, Guerra C A, Noor A M, Myint H Y, Hay S I. The global distribution of clinical episodes of Plasmodium falciparum malaria.  Nature. 2005;  434 (7030) 214-217
    CrossrefPubMedGoogle Scholar
  • 10 Walker M, Kublin J G, Zunt J R. Parasitic central nervous system infections in immunocompromised hosts: malaria, microsporidiosis, leishmaniasis, and African trypanosomiasis.  Clin Infect Dis. 2006;  42 (1) 115-125
    CrossrefPubMedGoogle Scholar
  • 11 Magowan C, Wollish W, Anderson L, Leech J. Cytoadherence by Plasmodium falciparum-infected erythrocytes is correlated with the expression of a family of variable proteins on infected erythrocytes.  J Exp Med. 1988;  168 (4) 1307-1320
    CrossrefPubMedGoogle Scholar
  • 12 Brown H C, Chau T T, Mai N T et al.. Blood-brain barrier function in cerebral malaria and CNS infections in Vietnam.  Neurology. 2000;  55 (1) 104-111
    CrossrefPubMedGoogle Scholar
  • 13 WHO . Severe falciparum malaria.  Trans R Soc Trop Hyg. 2000;  94 (Suppl 1) 1-90
    PubMedGoogle Scholar
  • 14 Newton C R, Hien T T, White N. Cerebral malaria.  J Neurol Neurosurg Psychiatry. 2000;  69 (4) 433-441
    CrossrefPubMedGoogle Scholar
  • 15 Han M H, Walker M, Zunt J R. Neurological infections in the returning international traveler.  Continuum: Lifelong learning in neurology. 2006;  12 (2) 133-158
    PubMedGoogle Scholar
  • 16 Molyneux M E, Taylor T E, Wirima J J, Borgstein A. Clinical features and prognostic indicators in paediatric cerebral malaria: a study of 131 comatose Malawian children.  Q J Med. 1989;  71 (265) 441-459
    PubMedGoogle Scholar
  • 17 Crawley J, Smith S, Kirkham F, Muthinji P, Waruiru C, Marsh K. Seizures and status epilepticus in childhood cerebral malaria.  QJM. 1996;  89 (8) 591-597
    CrossrefPubMedGoogle Scholar
  • 18 Crawley J, English M, Waruiru C, Mwangi I, Marsh K. Abnormal respiratory patterns in childhood cerebral malaria.  Trans R Soc Trop Med Hyg. 1998;  92 (3) 305-308
    CrossrefPubMedGoogle Scholar
  • 19 Marsh K, English M, Crawley J, Peshu N. The pathogenesis of severe malaria in African children.  Ann Trop Med Parasitol. 1996;  90 (4) 395-402
    PubMedGoogle Scholar
  • 20 Olumese P E, Gbadegesin R A, Adeyemo A A, Brown B, Walker A. Neurological features of cerebral malaria in Nigerian children.  Ann Trop Paediatr. 1999;  19 (4) 321-325
    CrossrefPubMedGoogle Scholar
  • 21 Beare N A, Taylor T E, Harding S P, Lewallen S, Molyneux M E. Malarial retinopathy: a newly established diagnostic sign in severe malaria.  Am J Trop Med Hyg. 2006;  75 (5) 790-797
    PubMedGoogle Scholar
  • 22 Maude R J, Beare N A, Abu Sayeed A et al.. The spectrum of retinopathy in adults with Plasmodium falciparum malaria.  Trans R Soc Trop Med Hyg. 2009;  103 (7) 665-671
    CrossrefPubMedGoogle Scholar
  • 23 Holding P A, Stevenson J, Peshu N, Marsh K. Cognitive sequelae of severe malaria with impaired consciousness.  Trans R Soc Trop Med Hyg. 1999;  93 (5) 529-534
    CrossrefPubMedGoogle Scholar
  • 24 Patankar T F, Karnad D R, Shetty P G, Desai A P, Prasad S R. Adult cerebral malaria: prognostic importance of imaging findings and correlation with postmortem findings.  Radiology. 2002;  224 (3) 811-816
    CrossrefPubMedGoogle Scholar
  • 25 Looareesuwan S, Wilairatana P, Krishna S et al.. Magnetic resonance imaging of the brain in patients with cerebral malaria.  Clin Infect Dis. 1995;  21 (2) 300-309
    CrossrefPubMedGoogle Scholar
  • 26 Tran T H, Day N P, Nguyen H P et al.. A controlled trial of artemether or quinine in Vietnamese adults with severe falciparum malaria.  N Engl J Med. 1996;  335 (2) 76-83
    CrossrefPubMedGoogle Scholar
  • 27 White N J. The treatment of malaria.  N Engl J Med. 1996;  335 (11) 800-806
    CrossrefPubMedGoogle Scholar
  • 28 Riddle M S, Jackson J L, Sanders J W, Blazes D L. Exchange transfusion as an adjunct therapy in severe Plasmodium falciparum malaria: a meta-analysis.  Clin Infect Dis. 2002;  34 (9) 1192-1198
    CrossrefPubMedGoogle Scholar
  • 29 McIntosh H M, Olliaro P. Treatment of severe malaria with artemisinin derivatives. A systematic review of randomised controlled trials.  Med Trop (Mars). 1998;  58 (3, Suppl) 61-62
    PubMedGoogle Scholar
  • 30 Eichenlaub D, Rogler G, Hoffmann H G, Weise H J. Falciparum malaria despite pyrimethamine/suifadoxine in five tourists to East Africa.  Lancet. 1982;  2 (8306) 1041-1042
    PubMedGoogle Scholar
  • 31 Newton C R, Crawley J, Sowumni A et al.. Intracranial hypertension in Africans with cerebral malaria.  Arch Dis Child. 1997;  76 (3) 219-226
    CrossrefPubMedGoogle Scholar
  • 32 Di Perri G, Di Perri I G, Monteiro G B et al.. Pentoxifylline as a supportive agent in the treatment of cerebral malaria in children.  J Infect Dis. 1995;  171 (5) 1317-1322
    CrossrefPubMedGoogle Scholar
  • 33 Ross A G, Bartley P B, Sleigh A C et al.. Schistosomiasis.  N Engl J Med. 2002;  346 (16) 1212-1220
    CrossrefPubMedGoogle Scholar
  • 34 Pollner J H, Schwartz A, Kobrine A, Parenti D M. Cerebral schistosomiasis caused by Schistosoma haematobium: case report.  Clin Infect Dis. 1994;  18 (3) 354-357
    CrossrefPubMedGoogle Scholar
  • 35 Betting L E, Pirani Jr C, de Souza Queiroz L, Damasceno B P, Cendes F. Seizures and cerebral schistosomiasis.  Arch Neurol. 2005;  62 (6) 1008-1010
    CrossrefPubMedGoogle Scholar
  • 36 Chitsulo L, Engels D, Montresor A, Savioli L. The global status of schistosomiasis and its control.  Acta Trop. 2000;  77 (1) 41-51
    CrossrefPubMedGoogle Scholar
  • 37 Scrimgeour E M. Non-traumatic paraplegia in northern Tanzania.  Br Med J (Clin Res Ed). 1981;  283 (6297) 975-978
    CrossrefPubMedGoogle Scholar
  • 38 Chen M G, Mott K E. Progress in the assessment of morbidity due to Schistosoma japonicum infection: a review of recent literature.  Trop Dis Bull. 1989;  86 R1-R36
    PubMedGoogle Scholar
  • 39 Betting L E, Pirani Jr C, de Souza Queiroz L, Damasceno B P, Cendes F. Seizures and cerebral schistosomiasis.  Arch Neurol. 2005;  62 (6) 1008-1010
    CrossrefPubMedGoogle Scholar
  • 40 Peregrino A JP, Oliviera R P, Porto C A et al.. Meningomieloradiculite por Schistosoma mansoni protocolo de investigação e registro de 21 casos.  Arq Neuropsiquiatr. 2002;  46 49-60
    PubMedGoogle Scholar
  • 41 Pittella J E. The relation between involvement of the central nervous system in Schistosomiasis mansoni and the clinical forms of the parasitosis. A review.  J Trop Med Hyg. 1991;  94 (1) 15-21
    PubMedGoogle Scholar
  • 42 Scrimgeour E M, Gajdusek D C. Involvement of the central nervous system in Schistosoma mansoni and S. haematobium infection. A review.  Brain. 1985;  108 (Pt 4) 1023-1038
    CrossrefPubMedGoogle Scholar
  • 43 Nascimento-Carvalho C M, Moreno-Carvalho O A. Neuroschistosomiasis due to Schistosoma mansoni: a review of pathogenesis, clinical syndromes and diagnostic approaches.  Rev Inst Med Trop Sao Paulo. 2005;  47 (4) 179-184
    CrossrefPubMedGoogle Scholar
  • 44 Ropper A H, Samuels M A. Adams and Victor's Principles of Neurology. 9th ed. New York, NY: McGraw-Hill Professional; 2005
    Google Scholar
  • 45 Shu K, Zhang S, Han L, Lei T. Surgical treatment of cerebellar schistosomiasis.  Neurosurgery. 2009;  64 (5) 941-943 discussion 943-944
    CrossrefPubMedGoogle Scholar
  • 46 Pittella J E, Lana-Peixoto M A. Brain involvement in hepatosplenic Schistosomiasis mansoni .  Brain. 1981;  104 (3) 621-632
    CrossrefPubMedGoogle Scholar
  • 47 Carod Artal F J, Vargas A P, Horan T A, Marinho P B, Coelho Costa P H. Schistosoma mansoni myelopathy: clinical and pathologic findings.  Neurology. 2004;  63 (2) 388-391
    CrossrefPubMedGoogle Scholar
  • 48 Gellido C L, Onesti S, Llena J, Suarez M. Spinal schistosomiasis.  Neurology. 2000;  54 (2) 527
    CrossrefPubMedGoogle Scholar
  • 49 Selwa L M, Brunberg J A, Mandell S H, Garofalo E A. Spinal cord schistosomiasis: a pediatric case mimicking intrinsic cord neoplasm.  Neurology. 1991;  41 (5) 755-757
    CrossrefPubMedGoogle Scholar
  • 50 Shu K, Zhang S, Han L, Lei T. Surgical treatment of cerebellar schistosomiasis.  Neurosurgery. 2009;  64 (5) 941-943 discussion 943-944
    CrossrefPubMedGoogle Scholar
  • 51 Betting L E, Pirani Jr C, de Souza Queiroz L, Damasceno B P, Cendes F. Seizures and cerebral schistosomiasis.  Arch Neurol. 2005;  62 (6) 1008-1010
    CrossrefPubMedGoogle Scholar
  • 52 da Rocha A J, Maia Jr A C, Ferreira N P, do Amaral L L. Granulomatous diseases of the central nervous system.  Top Magn Reson Imaging. 2005;  16 (2) 155-187
    CrossrefPubMedGoogle Scholar
  • 53 Liu H C, Lim C C, Feng X et al.. MRI in cerebral schistosomiasis: characteristic nodular enhancement in 33 patients.  AJR Am J Roentgenol. 2008;  191 (2) 582-588
    CrossrefPubMedGoogle Scholar
  • 54 Bill P L, Shakir R A, Newman P K, Posner C M eds.. Schistosomiasis. Tropical Neurology. Philadelphia, PA: WB Saunders Co; 1996: 295-316
    Google Scholar
  • 55 Lighter J, Kim M, Krasinski K. Intramedullary schistosomiasis presenting in an adolescent with prolonged intermittent back pain.  Pediatr Neurol. 2008;  39 (1) 44-47
    CrossrefPubMedGoogle Scholar
  • 56 Silva L C, Maciel P E, Ribas J G, Souza-Pereira S R, Antunes C M, Lambertucci J R. Treatment of schistosomal myeloradiculopathy with praziquantel and corticosteroids and evaluation by magnetic resonance imaging: a longitudinal study.  Clin Infect Dis. 2004;  39 (11) 1618-1624
    CrossrefPubMedGoogle Scholar
  • 57 Ross A G, Bartley P B, Sleigh A C et al.. Schistosomiasis.  N Engl J Med. 2002;  346 (16) 1212-1220
    CrossrefPubMedGoogle Scholar
  • 58 Fowler R, Lee C, Keystone J S. The role of corticosteroids in the treatment of cerebral schistosomiasis caused by Schistosoma mansoni: case report and discussion.  Am J Trop Med Hyg. 1999;  61 (1) 47-50
    PubMedGoogle Scholar
  • 59 Carod Artal F J, Vargas A P, Horan T A, Marinho P B, Coelho Costa P H. Schistosoma mansoni myelopathy: clinical and pathologic findings.  Neurology. 2004;  63 (2) 388-391
    CrossrefPubMedGoogle Scholar
  • 60 Ferrari T C. Involvement of central nervous system in the schistosomiasis.  Mem Inst Oswaldo Cruz. 2004;  99 (5, Suppl 1) 59-62
    CrossrefPubMedGoogle Scholar
  • 61 García H H, Gonzalez A E, Evans C AW, Gilman R H. Cysticercosis Working Group in Peru . Taenia solium cysticercosis.  Lancet. 2003;  362 (9383) 547-556
    CrossrefPubMedGoogle Scholar
  • 62 Román G, Sotelo J, Del Brutto O et al.. A proposal to declare neurocysticercosis an international reportable disease.  Bull World Health Organ. 2000;  78 (3) 399-406
    PubMedGoogle Scholar
  • 63 Senanayake N, Román G C. Epidemiology of epilepsy in developing countries.  Bull World Health Organ. 1993;  71 (2) 247-258
    PubMedGoogle Scholar
  • 64 Pittella J E. Neurocysticercosis.  Brain Pathol. 1997;  7 (1) 681-693
    CrossrefPubMedGoogle Scholar
  • 65 Ong S, Talan D A, Moran G J EMERGEncy ID NET Study Group et al. Neurocysticercosis in radiographically imaged seizure patients in U.S. emergency departments.  Emerg Infect Dis. 2002;  8 (6) 608-613
    CrossrefPubMedGoogle Scholar
  • 66 Schantz P M, Moore A C, Muñoz J L et al.. Neurocysticercosis in an Orthodox Jewish community in New York City.  N Engl J Med. 1992;  327 (10) 692-695
    CrossrefPubMedGoogle Scholar
  • 67 Garg R K. Diagnostic criteria for neurocysticercosis: some modifications are needed for Indian patients.  Neurol India. 2004;  52 (2) 171-177
    PubMedGoogle Scholar
  • 68 Wallin M T, Kurtzke J F. Neurocysticercosis in the United States: review of an important emerging infection.  Neurology. 2004;  63 (9) 1559-1564
    CrossrefPubMedGoogle Scholar
  • 69 Allan J C, Wilkins P P, Tsang V C, Craig P S. Immunodiagnostic tools for taeniasis.  Acta Trop. 2003;  87 (1) 87-93
    CrossrefPubMedGoogle Scholar
  • 70 Garcia H H, Del Brutto O H. Cysticercosis Working Group in Peru . Neurocysticercosis: updated concepts about an old disease.  Lancet Neurol. 2005;  4 (10) 653-661
    CrossrefPubMedGoogle Scholar
  • 71 Evans C AW. The Cysticercosis Working Group in Peru .The immunology of the host-parasite relationship in Taenia solium cysticercoids: implications for prevention and therapy. In: Garcia H H, Martinez S M, eds. Taenia Solium Taeniasis/Cysticercoids. 2nd ed. Lima: Ed Universo; 1999: 25-37
    Google Scholar
  • 72 Garcia H H, Del Brutto O H. Cysticercosis Working Group in Peru . Neurocysticercosis: updated concepts about an old disease.  Lancet Neurol. 2005;  4 (10) 653-661
    CrossrefPubMedGoogle Scholar
  • 73 Flisser A. Taeniasis and cysticercosis due to Taenia solium .  Prog Clin Parasitol. 1994;  4 77-116
    PubMedGoogle Scholar
  • 74 Flisser A, Correa D, Evans C AW. Taenia solium cysticercoids: new and revisited immunological aspects. In: Singh G, Prabhakar S, eds. Taenia Solium Cysticercoids: From Basic to Clinical Science. Wallingford: CABI Publishing; 2002: 15-24
    Google Scholar
  • 75 Pittella J E. Neurocysticercosis.  Brain Pathol. 1997;  7 (1) 681-693
    CrossrefPubMedGoogle Scholar
  • 76 Hawk M W, Shahlaie K, Kim K D, Theis J H. Neurocysticercosis: a review.  Surg Neurol. 2005;  63 (2) 123-132 discussion 132
    CrossrefPubMedGoogle Scholar
  • 77 Del Brutto O H, Sotelo J. Neurocysticercosis: an update.  Rev Infect Dis. 1988;  10 (6) 1075-1087
    CrossrefPubMedGoogle Scholar
  • 78 Carpio A, Escobar A, Hauser W A. Cysticercosis and epilepsy: a critical review.  Epilepsia. 1998;  39 (10) 1025-1040
    CrossrefPubMedGoogle Scholar
  • 79 Del Brutto O H, Santibañez R, Noboa C A, Aguirre R, Díaz E, Alarcón T A. Epilepsy due to neurocysticercosis: analysis of 203 patients.  Neurology. 1992;  42 (2) 389-392
    CrossrefPubMedGoogle Scholar
  • 80 Cantú C, Barinagarrementeria F. Cerebrovascular complications of neurocysticercosis. Clinical and neuroimaging spectrum.  Arch Neurol. 1996;  53 (3) 233-239
    CrossrefPubMedGoogle Scholar
  • 81 Couldwell W T, Zee C S, Apuzzo M L. Definition of the role of contemporary surgical management in cisternal and parenchymatous cysticercosis cerebri.  Neurosurgery. 1991;  28 (2) 231-237
    CrossrefPubMedGoogle Scholar
  • 82 Escobar A. The pathology of neurocysticercosis. In: Palacios E, Rodriguez-Carbajal J, Taveras J M, eds. Cysticercosis of the Central Nervous System. Springfield, IL: Charles C. Thomas; 1983: 27-54
    Google Scholar
  • 83 Latovitzki N, Abrams G, Clark C, Mayeux R, Ascherl G, Sciarra D. Cerebral cysticercosis.  Neurology. 1978;  28 (8) 838-842
    CrossrefPubMedGoogle Scholar
  • 84 Gogia S, Talukdar B, Choudhury V, Arora B S. Neurocysticercosis in children: clinical findings and response to albendazole therapy in a randomized, double-blind, placebo-controlled trial in newly diagnosed cases.  Trans R Soc Trop Med Hyg. 2003;  97 (4) 416-421
    CrossrefPubMedGoogle Scholar
  • 85 Akiguchi I, Fujiwara T, Matsuyama H, Muranaka H, Kameyama M. Intramedullary spinal cysticercosis.  Neurology. 1979;  29 (11) 1531-1534
    CrossrefPubMedGoogle Scholar
  • 86 Garcia H H, Martinez S M. Taenia Solium Taeniasis/Cysticercoids. 2nd ed. Lima, Peru: Editorial Universo; 1999
    Google Scholar
  • 87 Webbe G. Human cysticercosis: parasitology, pathology, clinical manifestations and available treatment.  Pharmacol Ther. 1994;  64 (1) 175-200
    CrossrefPubMedGoogle Scholar
  • 88 Del Brutto O H, Wadia N H, Dumas M, Cruz M, Tsang V C, Schantz P M. Proposal of diagnostic criteria for human cysticercosis and neurocysticercosis.  J Neurol Sci. 1996;  142 (1-2) 1-6
    CrossrefPubMedGoogle Scholar
  • 89 Wilson M, Bryan R T, Fried J A et al.. Clinical evaluation of the cysticercosis enzyme-linked immunoelectrotransfer blot in patients with neurocysticercosis.  J Infect Dis. 1991;  164 (5) 1007-1009
    CrossrefPubMedGoogle Scholar
  • 90 Garcia H H, Del Brutto O H. Cysticercosis Working Group in Peru . Neurocysticercosis: updated concepts about an old disease.  Lancet Neurol. 2005;  4 (10) 653-661
    CrossrefPubMedGoogle Scholar
  • 91 Garcia H H, Del Brutto O H, Nash T E, White Jr A C, Tsang V C, Gilman R H. New concepts in the diagnosis and management of neurocysticercosis (Taenia solium).  Am J Trop Med Hyg. 2005;  72 (1) 3-9
    PubMedGoogle Scholar
  • 92 Schantz P M, Moore A C, Muñoz J L et al.. Neurocysticercosis in an Orthodox Jewish community in New York City.  N Engl J Med. 1992;  327 (10) 692-695
    CrossrefPubMedGoogle Scholar
  • 93 Chang K H, Lee J H, Han M H, Han M C. The role of contrast-enhanced MR imaging in the diagnosis of neurocysticercosis.  AJNR Am J Neuroradiol. 1991;  12 (3) 509-512
    PubMedGoogle Scholar
  • 94 Sheth T N, Pillon L, Keystone J, Kucharczyk W. Persistent MR contrast enhancement of calcified neurocysticercosis lesions.  AJNR Am J Neuroradiol. 1998;  19 (1) 79-82
    PubMedGoogle Scholar
  • 95 Escobar A. The pathology of neurocysticercosis. In: Palacios E, Rodriguez-Carbajal J, Taveras J M, eds. Cysticercosis of the Nervous System. Springfield, IL: Charles C Thomas; 1983
    Google Scholar
  • 96 Del Brutto O H, Wadia N H, Dumas M, Cruz M, Tsang V C, Schantz P M. Proposal of diagnostic criteria for human cysticercosis and neurocysticercosis.  J Neurol Sci. 1996;  142 (1-2) 1-6
    CrossrefPubMedGoogle Scholar
  • 97 Takayanagui O M, Jardim E. Therapy for neurocysticercosis. Comparison between albendazole and praziquantel.  Arch Neurol. 1992;  49 (3) 290-294
    CrossrefPubMedGoogle Scholar
  • 98 Vazquez V, Sotelo J. The course of seizures after treatment for cerebral cysticercosis.  N Engl J Med. 1992;  327 (10) 696-701
    CrossrefPubMedGoogle Scholar
  • 99 Apuzzo M L, Dobkin W R, Zee C S, Chan J C, Giannotta S L, Weiss M H. Surgical considerations in treatment of intraventricular cysticercosis. An analysis of 45 cases.  J Neurosurg. 1984;  60 (2) 400-407
    CrossrefPubMedGoogle Scholar
  • 100 Singh G, Rajshekhar V, Murthy J M et al.. A diagnostic and therapeutic scheme for a solitary cysticercus granuloma.  Neurology. 2010;  75 (24) 2236-2245
    CrossrefPubMedGoogle Scholar

Kiran ThakurM.D. 

Massachusetts General Hospital

55 Fruit Street, Boston, MA 02115

Email: kthakur@partners.org

      >