Neurocysticercosis

Oscar H. Del Brutto, MD

Disclosures

Semin Neurol. 2005;25(3):243-251. 

In This Article

Abstract and Introduction

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.

Neurocysticercosis (NCC) is the most common helminthic disease of the nervous system and represents a threat to millions of people living in the developing countries of Latin America, Africa, and Asia. In endemic regions, NCC is a leading cause of hospital admissions and the major cause of acquired epilepsy.[1] Massive immigration of people from endemic to nonendemic areas has produced a recent increase in the prevalence of NCC in North America and some European countries, where previously this condition was rare.[2] More than 50,000 deaths due to NCC occur every year, and many more patients survive the disease but are left with irreversible brain damage. This makes NCC a major public health problem as most affected people are at productive ages. Eradication of cysticercosis must be a public health priority during the next decades.[3,4]

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