OBJECTIVE: 

Infection with the pork tapeworm can result in neurocysticercosis caused by infestation of central nervous system tissues by the parasite cysts. Parenchymal brain infection can cause symptoms from mass effect that include headache, seizures, confusion, and even coma. Our objective was to describe the clinical course of neurocysticercosis infections in pregnant women.

METHODS: 

This was a case series that described clinical findings and pregnancy outcomes of women diagnosed with neurocysticercosis from 1994 through 2016 at a single institution. Their medical records were reviewed, cranial computed tomography and magnetic resonance imaging scans were assessed, and the infections were classified according to the criteria of the 2018 Infectious Diseases Society of America and the American Society of Tropical Medicine and Hygiene.

RESULTS: 

Overall, 37 pregnant women with neurocysticercosis were identified. Of the 37 women, 32 were symptomatic, and 16 each had severe headaches or new-onset seizures or other neurologic sequelae. Some of these women had multiple symptoms. Others were diagnosed when neuroimaging was done for a history of neurocysticercosis or evaluation of a preexisting seizure disorder. The most common treatment was with anthelmintics—albendazole, praziquantel, or both—usually given with anticonvulsants and corticosteroids to decrease inflammation. There were eight women in whom invasive neurosurgical procedures were performed, usually for hydrocephaly. Overall, 32 healthy neonates were born at term, and there was one preterm delivery at 34 weeks of gestation. The four pregnancy losses included two molar pregnancies, one anembryonic miscarriage, and a 23-week stillbirth of a pregnancy complicated by preeclampsia with severe features.

CONCLUSION: 

Neurocysticercosis in pregnant women may be asymptomatic or result in headaches, seizures, confusion, nausea and vomiting, altered mental status, or obtundation. Anthelmintic treatment is usually successful, but in some women neurosurgical procedures are necessary to relieve obstructive hydrocephaly.

中文翻译：

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妊娠合并神经囊尾蚴病

客观的： 

感染猪肉绦虫可导致由寄生虫包囊侵染中枢神经系统组织引起的神经囊尾蚴病。脑实质感染可引起肿块效应的症状，包括头痛、癫痫发作、精神错乱，甚至昏迷。我们的目的是描述孕妇神经囊尾蚴病感染的临床过程。

方法： 

这是一个病例系列，描述了从 1994 年到 2016 年在一个机构中诊断为神经囊尾蚴病的女性的临床发现和妊娠结局。审查了他们的病历，评估了颅脑 CT 和磁共振成像扫描，并根据 2018 年美国传染病学会和美国热带医学与卫生学会的标准对感染进行了分类。

结果： 

总共确定了 37 名患有神经囊尾蚴病的孕妇。在 37 名女性中，32 名有症状，每人 16 名有严重头痛或新发癫痫或其他神经系统后遗症。其中一些女性有多种症状。其他人是在对神经囊尾蚴病史进行神经影像学检查或评估先前存在的癫痫症时诊断出来的。最常见的治疗是使用驱虫药——阿苯达唑、吡喹酮或两者兼有——通常与抗惊厥药和皮质类固醇一起使用以减轻炎症。有 8 名女性接受了侵入性神经外科手术，通常是针对脑积水。总体而言，32 名健康新生儿足月出生，其中 1 名在妊娠 34 周时早产。四次流产包括两次葡萄胎妊娠、一次无胚胎流产、

结论： 

孕妇的神经囊尾蚴病可能无症状或导致头痛、癫痫发作、精神错乱、恶心和呕吐、精神状态改变或迟钝。驱虫治疗通常是成功的，但在一些女性中，神经外科手术对于缓解阻塞性脑积水是必要的。