Neurocysticercosis: a review of current status and management

Neurocysticercosis (NCC) is an infection of the brain and its coverings by the larval stage of the tapeworm Taenia solium. It is the most common helminthic infestation of the central nervous system and a leading cause of acquired epilepsy worldwide. NCC induces neurological syndromes that vary from an asymptomatic infection to sudden death. Neuroimaging is the mainstay of diagnosis. The diagnosis is suggested in patients living in endemic areas with typical CT scan findings and a compatible clinical picture. Since the late 1980s, successful medical treatment has been established with relatively short courses of either albendazole or praziquantel. The selection of cases for medical or surgical treatments has improved and these two forms of therapy are complementary. In general, indications of surgery are: cysts that compress the brain and cranial nerves locally, intracranial hypertension or edema refractory to medical treatment, intraventricular NCC, spinal NCC with cord or root compression and ocular cysts. Recently, endoscopic approaches for ventricular NCC have been developed, which are now the treatment of choice for ventricular NCC with hydrocephalus.