Cysticercosis: Recent advances in diagnosis and management of neurocysticercosis

Neurocysticercosis, caused by infection with the pork tapeworm Taenia solium, is increasingly recognized as a cause of neurologic disease worldwide. Because the clinical presentation is nonspecific, diagnosis has been difficult. Advances in imaging studies and serodiagnostic techniques are facilitating the diagnosis of neurocysticercosis and tapeworm carriers. Neurocysticercosis represents a spectrum of disease. Seizures are the main clinical manifestation in parenchymal neurocysticercosis. Recent studies emphasize that such seizures are the result of the host inflammatory response, even in patients who only have calcifications with no viable cysticerci. Controlled clinical trials have demonstrated that antiparasitic drugs can decrease the number of generalized seizures, although the benefit is small and confined to a subgroup of patients. Corticosteroids can also decrease seizure frequency. Case studies have demonstrated that endoscopic surgery appears to be the optimal approach to ventricular cysts. Recombinant vaccines are being developed and may prove important in disease control.