Spinal neurocysticercosis: synthesizing evidence on clinical presentations, anatomical patterns, diagnostic approaches, and therapeutic strategies

Spinal neurocysticercosis (NCC) is an uncommon manifestation of NCC involving the spinal cord, meninges, nerve roots, and subarachnoid spaces. Although less common than intracranial disease, spinal involvement can cause substantial neurological morbidity because even small lesions within the confined spinal canal may produce progressive myelopathy. Disease may result from hematogenous dissemination or cerebrospinal fluid (CSF) spread of Taenia solium larvae and may present as intramedullary, intradural extramedullary, subarachnoid, or, rarely, extradural lesions. Clinical manifestations are diverse and include paraparesis, quadriparesis, cauda equina syndrome, and chronic meningitis. Magnetic resonance imaging is the diagnostic modality of choice, providing detailed assessment of lesion location, evolutionary stage, inflammatory activity, and associated complications. CSF analysis and immunological or molecular tests provide supportive evidence, while histopathological examination confirms the diagnosis when tissue is available. Treatment is individualized and may include antiparasitic agents, corticosteroids, and surgery when indicated. Although outcomes are generally favorable with early diagnosis and appropriate treatment, delayed treatment, extensive arachnoiditis, diffuse leptomeningeal disease, and established spinal cord damage may result in permanent neurological deficits. Further prospective studies are needed to refine diagnostic strategies and optimize management. PubMed database was searched from inception to 13 July 2026, for spinal neurocysticercosis and spinal cysticercosis.