Neurocysticercosis

Abstract

Neurocysticercosis is the most common helminthic disease of the nervous system and currently represents a major public health problem in developing countries of Latin America, Asia, and Africa, as well as in industrialized nations with a high immigration rate of people from endemic areas. The disease occurs when humans become the intermediate host in the life cycle of Taenia solium by ingesting its eggs from contaminated food. Neurocysticercosis is pleomorphic in its presentation due to individual differences in the number, size, and location of the parasites, as well as differences in the severity of the host's immune reaction to the parasite. Epilepsy, focal neurological signs, and intracranial hypertension are the most common clinical manifestations of the disease. The diagnosis of neurocysticercosis is based on clinical data, neuroimaging abnormalities, and the results of immunological tests. Two drugs, albendazole and praziquantel, are cysticidal and destroy most intracranial parasites; however, surgery may be necessary in the management of some forms of the disease, particularly hydrocephalus and intraventricular cysts. Although the development of modern diagnostic tests and the introduction of potent cestocidal drugs have increased our ability to make the diagnosis of neurocysticercosis and improved prognosis, some patients still have a torpid clinical course despite prompt diagnosis and proper therapy.