Why Neurodiagnostic Technologists Need to Know About Neurocysticercosis

Inadequate running water, poor pest control, and improper waste disposal are prerequisites for any number of infectious diseases and parasites. That’s overseas, though – not America, right?

Wrong.

The novel coronavirus has taught us all that we are not immune to large-scale infectious disease. And many don’t know there is a disease caused by a brain-infecting tapeworm that researchers say has been growing in the U.S. over the last decade: neurocysticercosis.

The World Health Organization, the National Institutes of Health, and the Centers for Disease Control and Infection have all identified this disease as a “neglected parasitic infection,” or NPI. This is because the numbers are up, it can be deadly, and the disease is preventable. These groups have put out a call to raise awareness.

Neurodiagnostic technologists, in particular, need to know about this disease. Why? It causes epilepsy. There’s even a question about it on the CLTM certification exam.

That’s according to Petra Davidson, an EEG technologist who spoke about the disease at the recent annual meeting of ASET-the Diagnostic Society. Davidson is co-author of the 2020 updated infection control guidelines, published in the Neurodiagnostic Journal.

Neurocysticercosis is an infection of the central nervous system. It is caused by the presence of calcified cysts that form around the eggs of a tapeworm in the family taenia solium. Entering the body through tainted meat or fecal matter, the eggs hatch into adult tapeworms, which in turn can lay thousands of eggs.

The eggs can be mobile and infect many systems of the body. When they get into the nervous system and brain, they can cause a range of neurological and psychiatric problems, including headaches, seizures, confusion, stroke and dementia.

“Researchers report that approximately 5 million cases of epilepsy worldwide are due to neurocysticercosis,” said Davidson.

The disease can also be fatal. The symptoms and their severity depend on the location of infestation and are most closely associated with the presence of cysts — sometimes hundreds of them.

The CLTM exam includes an image to be identified showing these cysts in the brain, said Davidson. The worm itself “has a ribbon-like appearance and has a head full of suckers and gripping teeth.” The worm can grow as long as an adult male giraffe is tall.

Treatment includes reducing inflammation and intracranial hypertension along with removal of cysts and the adult tapeworms. If the head isn’t identified and removed, it can regenerate into a whole new tapeworm, she said.

Making the correct diagnosis and catching the disease in time for treatment can be tricky. Most experts agree that, for this reason, the patient count is largely underestimated. In 2017, according to Davidson, researchers estimated there were more than 2,000 cases of neurocysticercosis every year in the U.S. Treatment costs run to nearly $100 million annually. And those numbers, she says, appear to be growing.

Prevention is the most powerful tool we have against neurocysticercosis.

“This is a disease which can be managed, but requires identification, education, and treatment to prevent it from getting out of control,” Davidson added.

In the U.S., the most common way people get neurocysticercosis is through fecal-oral transmission.

“The same way e-coli spreads on lettuce and other vegetables, it can make us sick,” said Davidson. “It’s spread on the hands from food that is not properly cooked or properly cleaned and washed. You touch it, you touch your face, it gets into the digestive tract. That’s the most common way for this to be transmitted to people.”

She urges neurodiagnostic technologists to help raise awareness about this disease and to say something if they suspect it in a patient. In the meantime, we all have one more reason to be washing our hands – and in this case, hand sanitizer just won’t cut it, she says.

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