Management of neurocysticercosis

Abstract

Background: Neurocysticercosis is a parasitic infection of the central nervous system caused by the larval stage of the tapeworm Taenia solium and is the most common parasitic infection involving the human nervous system. Neurocysticercosis represents one of the most common causes of symptomatic epilepsy in developing countries and is an increasing concern in industrialized nations.

Methods: We conducted a review of the medical literature regarding the current management of neurocysticercosis in Latin American countries.

Results: Mexico and Brazil report the highest incidence of neurocysticercosis in Latin America. However, major obstacles interfere with an accurate determination of the prevalence of neurocysticercosis, including the lack of standardized and comprehensive epidemiological systems, intrinsic limitations of current immunological studies, the high cost of neuroimaging studies in rural communities and the presence of asymptomatic patients with neuroimaging characteristic compatible with neurocysticercosis. As such, the real prevalence of the disease and its burden are likely underestimated in Latin America. There is no universal consensus or guidelines for the management of different forms of the disease, but most experts agree in the use of antihelminithic therapy when viable cysts are encountered and with the use of corticosteroids in patients presenting with encephalitis.

Discussion: Neurocysticercosis is a pleomorphic disease, with a broad spectrum of clinical and radiographic features. The medical management of neurocysticercosis is complex and needs to be individualized.