Neurocysticercosis: current diagnostic and treatment paradigms

Neurocysticercosis, the infestation of the human central nervous system by Taenia solium cysts, accounts for a significant burden of neurological disorders in endemic regions. It is a neglected tropical disease and, hence, often overlooked. However, its importance is underscored by the high burden of epilepsy in endemic regions and many imported cases in nonendemic areas. Given recent epidemiological shifts and advances in diagnosis and treatment, a new focus on neurocysticercosis is required.

While South & Central America remain endemic, sub-Saharan Africa has emerged as a newly recognized hotspot. Recent developments include the potential for antigen-based assays to facilitate 'point of care' diagnosis and treatment monitoring, the combination of antiparasitic regimens, and a newer antiparasitic agent, oxfendazole, currently in clinical trial.

Recent developments offer significant hope. Wider access to neuroimaging, improved serological tests including antigen assays, and novel therapeutic strategies such as combination antiparasitic treatment have improved outcomes. Ultimately, however, a concerted prevention strategy incorporating diverse approaches will be crucial in reducing the global burden of neurological disorders associated with neurocysticercosis.