Case submitted by Francis Roy, USU
Discussion: This disorder is endemic to every continent except Australia. It is in most cases caused by the cysticercus of Taenia solium (the pig tapeworm, see figure 1). Man can be the definitive host as well as an intermediate host. The mature adult sheds proglottid segments in the intestinal track of man. Within the proglottid segment are many eggs or oncospheres, each within a shell. These are then ingested by a pig or a human. The gastric juice begins to break down the shell. Within the duodenum the oncosphere is released. These oncospheres penetrate through the intestinal wall into mesenteric venules and are carried throughout the body. In 60-70 days these oncospheres metamorphose into cysticerci. The body at first forms a fibrous capsule around it. Then over a period of months to years the cysticerci dies and becomes calcified. Cysticerci are most commonly found in the subcutaneous tissues and the muscles of the tongue, neck or ribs. The eye and brain are the next most commonly found sites. The subcutaneous cysticerci usually do not cause any symptomatology. The eye and brain cysticerci are usually the reason why the person presents to a physician.


Computed tomography is the best method of determining the location of the cysticerci. That then can be followed by biopsy to confirm the diagnosis. The most common causes of death are status epilepticus and intracranial hypertension.

Treatment:
Treatment consist of praziquantel, 30mg/kg in three divided doses daily for six days. This may have to be repeated in one to two months in conjunction with corticosteroids.