Neurocysticercosis - Practical treatment guidelines

Abstract

Neurocysticercosis is, worldwide, the most frequently occurring parasitic disease of the brain. Its clinical picture is complex and so the disorder may present in various forms that range from a benign self-limited disorder to a severe life-threatening condition.Therapeutic approaches must be selected for each patient according to the number, location and stage of cysticerci, and the degree of the inflammatory response raised by the host against the parasites. Cysticercosis of brain parenchyma, including clumps and giant cysts, respond well to cestocidal drugs and have a good prognosis. In cases of ventricular cysticercosis, cestocidal drugs and surgery, alone or in combination, usually produce good results. Cysticercotic meningitis, accompanied by hydrocephalus, vasculitis and widespread chronic inflammation in the subarachnoid space, is a therapeutic challenge. These cases frequently have a poor prognosis due to secondary complications.Efforts to eradicate cysticercosis must emphasise public health measures of sanitation and extensive education about the mechanisms of transmission.