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Review
. 2022 May;80(5 Suppl 1):296-306.
doi: 10.1590/0004-282X-ANP-2022-S115.

Update on the diagnosis and management of neurocysticercosis

Osvaldo Massaiti Takayanagui  1 , Tissiana Marques de Haes  1
Affiliations
Review

Update on the diagnosis and management of neurocysticercosis

Osvaldo Massaiti Takayanagui et al. Arq Neuropsiquiatr. 2022 May.

Abstract
in English, Portuguese

Background: Neurocysticercosis (NCC) is a serious public health problem in several developing countries, including those in Latin America, Asia, and Africa. NCC is considered to be the main cause of late-onset epilepsy in endemic areas.

Objective: This review summarizes recent advances in diagnosis and therapy of NCC. Methods: Relevant articles and books were reviewed and used as a source of information for this review.

Results: The diagnosis of NCC is based upon neuroimaging studies (MRI and computed tomography) and laboratory analysis of the cerebrospinal fluid (CSF). Praziquantel and albendazole are considered parasiticidal drugs against NCC, but there is an intense debate over the value and safety of these drugs.

Conclusion: Given the relative scarcity of clinical trials, more comparative interventional studies, especially randomized controlled trials in long-term clinical evolution, are required in order to clarify the controversy over the validity of parasitic therapy in patients with NCC.

Antecedentes:: A neurocisticercose (NCC) é grave problema de saúde pública nos países em desenvolvimento, especialmente na América Latina, Ásia e África. A NCC é considerada a principal causa de epilepsia de início tardio nas regiões endêmicas. Objetivo: Este artigo pretende discutir os recentes avanços no diagnóstico e tratamento da NCC.

Métodos:: Artigos científicos e livros relevantes serviram de fonte de informação para esta revisão.

Resultados:: O diagnóstico da NCC é fundamentado nos exames de neuroimagem (ressonância magnética e tomografia computadorizada) e do líquido cefalorraquiano (LCR). Atualmente, praziquantel e albendazole são considerados eficazes na terapêutica etiológica da NCC, mas há intenso debate quanto à validade e segurança desses medicamentos.

Conclusão:: Pela relativa carência de ensaios clínicos, são necessários novos estudos particularmente randomizados, controlados e com análise de desfechos clínicos a longo prazo para o esclarecimento da polêmica envolvendo a validade da terapêutica parasiticida na NCC.

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Conflict of interest statement

Conflict of interest: There is no conflict of interest to declare.

Figures

Figure 1.
Figure 1.. MRI intraparenchymal viable cysticercus with scolex.
Figure 2.
Figure 2.. MRI multiple intraparenchymal viable cysticerci.
Figure 3.
Figure 3.. MRI intraventricular cysticercosis.
Figure 4.
Figure 4.. MRI multiple giant cysticerci.
Figure 5.
Figure 5.. MRI subarachnoid racemose cysticercosis, involving basal cisterns.
See this image and copyright information in PMC

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