Neurocysticercosis

Abstract

Neurocysticercosis occurs when humans become intermediate hosts in the life cycle of Taenia solium by ingesting its eggs directly from a taenia carrier or, less often, by contaminated food. Within the nervous system, cysticerci may lodge in the brain parenchyma, subarachnoid space, ventricular system, or spinal cord, causing a number of pathologic changes that are responsible for the pleomorphism of neurocysticercosis. This article discusses the clinical manifestations, diagnosis, and treatment of neurocysticercosis. Formerly endemic in the developing world, mass immigration of people from disease-endemic to nonendemic areas has caused a recent increase in the prevalence of neurocysticercosis in developed countries, where this condition should no longer be considered exotic. Recent advances in neuroimaging and immune diagnostic methods, and the introduction of a set of diagnostic criteria, have enhanced the diagnostic accuracy for neurocysticercosis. Likewise, introduction of potent cysticidal drugs has radically changed its prognosis. Neurocysticercosis is the most common helminthic infection of the CNS and a major cause of acquired epilepsy worldwide. Diagnosis of neurocysticercosis is possible after interpretation of clinical data together with findings of neuroimaging studies and results of immunologic tests in a proper epidemiologic context. The use of cysticidal drugs reduces the burden of infection in the brain and improves the clinical course of most patients. Further efforts must be directed to eradicate the disease through the implementation of control programs against all interrelated steps in the life cycle of T. solium, including human carriers of the adult tapeworm, infected pigs, and eggs in the environment.