successful, can potentially have a great impact on transmission control since there is no chance of re-infection once pigs receive vaccination. other cysticercosis can also be prevented by routine inspection of meat and condemnation of measly meat by the local government and by avoiding partially cooked meat products. however, in areas where food is scarce, cyst-infected meat might be considered as wasted since pork can provide high quality protein. at times, infected pigs are consumed within the locality or sold at low prices to traffickers who take the uninspected pigs at urban areas for sale. management neurocysticercosis asymptomatic cysts, such as those discovered incidentally on neuroimaging done for another reason, may never lead to symptomatic disease and in many cases do not require therapy. calcified cysts have already died and involuted. seizures can also occur in individuals with only calcified cysts. neurocysticercosis may present as hydrocephalus and acute onset seizures, thus the immediate therapy is emergent reduction of intracranial pressure and anticonvulsant medications. once the seizures have been brought under control, antihelminthic treatments may be undertaken. the decision to treat with antiparasitic therapy is complex and based on the stage and number of cysts present, their location, and the persons specific symptoms. adult taenia solium are easily treated with niclosamide, and is most commonly used in taeniasis. however cysticercosis is a complex disease and requires careful medication. praziquantel (pzq) is the drug of choice. in neurocysticercosis praziquantel is widely used. albendazole appears to be more effective and a safe drug for neurocysticercosis. in complicated situation a combination of praziquantel, albendazole and steroid (such as corticosteroids to reduce the inflammation) is recommended. in the brain the cysts can be usually found on the surface. most cases of brain cysts are found by accident, during diagnosis for other ailments. surgical removals are the only option of complete removal even if treated successfully with medications. antiparasitic treatment should be given in combination with corticosteroids and anticonvulsants to reduce inflammation surrounding the cysts and lower the risk of seizures. when corticosteroids are given in combination with praziquantel, cimetidine is also given, as corticosteroids decrease action of praziquantel by enhancing its first pass metabolism. albendazole is generally preferable over praziquantel due to its lower cost and fewer drug interactions. surgical intervention is much more likely to be needed in cases of intraventricular, racemose, or spinal neurocysticercosis. treatments includes direct excision of ventricular cysts, shunting procedures, and removal of cysts via endoscopy. eyes in eye disease, surgical removal is necessary for cysts within the eye itself as treating intraocular lesions with anthelmintics will elicit an inflammatory reaction causing irreversible damage to structural components. cysts outside the globe can be treated with anthelmintics and steroids. treatment recommendations for subcutaneous cysticercosis includes surgery, praziquantel and albendazole. skin in general, subcutaneous disease does not need specific therapy. painful or bothersome cysts can be surgically removed. epidemiology regions taenia solium is found worldwide, but is more common where pork is part of the diet. cysticercosis is most prevalent where humans live in close contact with pigs. therefore, high prevalences are reported in mexico, latin america, west africa, russia, india, pakistan, north-east china, and southeast asia. in europe it is most widespread among slavic people. however, reviews of the epidemiological in western and eastern europe shows there are still considerable gaps in our understanding of the disease also in these regions. the frequency has decreased in developed countries owing to stricter meat inspection, better hygiene and better sanitation of facilities. infection estimates in latin america, an estimated 75 million persons live in endemic areas and 400,000 people have symptomatic disease. some studies suggest that the prevalence of cysticercosis in mexico is between 3.1 and 3.9 percent. other studies have found the seroprevalence in areas of guatemala, bolivia, and peru as high as 20 percent in humans, and 37 percent in pigs. in ethiopia, kenya and the democratic republic of congo around 10% of the population is infected, in madagascar 16%. the distribution of cysticercosis coincides with the distribution of t. solium. cysticercosis is the most common cause of symptomatic epilepsy worldwide. prevalence rates in the united states have shown immigrants from mexico, central and south america, and southeast asia account for most of the domestic cases of cysticercosis. in 1990 and 1991, four unrelated members of an orthodox jewish community in new york city developed recurrent seizures and brain lesions, which were found to have been caused by t. solium. researchers who interviewed the families suspect the infection was acquired from domestic workers who were carriers of the tapeworm. deaths worldwide as of 2010 it caused about 1,200 deaths, up from 700 in 1990. estimates from 2010 were that it contributed to at least 50,000 deaths annually. in us during 1990–2002, 221 cysticercosis deaths were identified. mortality rates were highest for latinos and men. the mean age at death was 40.5 years (range 2–88). most patients, 84.6%, were foreign born, and 62% had emigrated from mexico. the 33 us-born persons who died of cysticercosis represented 15% of all cysticercosis-related deaths. the cysticercosis mortality rate was highest in california, which accounted for 60% of all cysticercosis deaths. history scolex (head) of taenia solium the earliest reference to tapeworms were found in the works of ancient egyptians that date back to almost 2000 bc. the description of measled pork in the history of animals written by aristotle (384–322 bc) showed that the infection of pork with tapeworm was known to ancient greeks at that time. it was also known to jewish and later to early muslim physicians and has been proposed as one of the reasons for pork being forbidden by jewish and islamic dietary laws. recent examination of evolutionary histories of hosts and parasites and dna evidence show that over 10,000 years ago, ancestors of modern humans in africa became exposed to tapeworm when they scavenged for food or preyed on antelopes and bovids, and later passed the infection on to domestic animals such as pigs. cysticercosis was described by johannes udalric rumler in 1555; however, the connection between tapeworms and cysticercosis had not been recognized at that time. around 1850, friedrich küchenmeister fed pork containing cysticerci of t. solium to humans awaiting execution in a prison, and after they had been executed, he recovered the developing and adult tapeworms in their intestines. by the middle of the 19th century, it was established that cysticercosis was caused by the ingestion of the eggs of t. solium.