Neurocysticercosis (NCC) is an infestation of the nervous system caused by encysted larvae of Taenia solium. NCC is an important acquired cause of epilepsy and other neurological manifestations especially in endemic areas. NCC in children has pleomorphic manifestations depending on the location, number, viability of the cysts, and host response. Even with advancing knowledge of the disease manifestations, many aspects related to diagnosis and treatment, particularly in children, still remain controversial and pose challenges to clinical practice. There is no gold standard test to diagnose NCC and the management recommendations are still emerging. This review provides an overview of diagnosis of NCC in children and its management with special focus on current challenges and future prospects.
In developing countries, NCC is important not only because of its frequency but also because of high morbidity and mortality rates associated, especially in cases in which it progresses to increased intracranial pressure. Because of its pleomorphic presentation, NCC should be considered in the differential diagnosis of a number of neurological conditions. Treatment with cysticidal therapy leads to reduction in seizure frequency and a faster resolution of lesions.
We have summarized the current approaches to diagnosis and treatment of NCC, recent advances in understanding the biology of NCC, and how one can take advantage of these new insights to formulate the next generation of clinical trials.
KeywordsBrain Cysticercosis Epilepsy Hydrocephalus Intracranial hypertension Parasitic disease Parenchymal cyst
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Conflict of interest
There was no financial support nor industry affiliations involved in this work. None of the authors has any personal or institutional financial interest in drugs, materials, or devices.
- 2.Blanton R (2007) Cysticercosis. In: Kliegman RM, Jenson HB, Behrman RE, Stanton BF (eds) Nelson textbook of Paediatrics. Saunders Elsevier pp, Philadelphia, pp 1514–1516Google Scholar
- 4.Colli BO, Carlotti CG Jr, Assirati JA Jr, Machado HR, Valença M, Amato MC (2002) Surgical treatment of cerebral cysticercosis: long-term results and prognostic factors. Neurosurg Focus 15(12):e3Google Scholar
- 5.Colli BO, Valença MM, Carlotti CG Jr, Machado HR, Assirati JA Jr (2002) Spinal cord cysticercosis: neurosurgical aspects. Neurosurg Focus 15(12):e9Google Scholar
- 11.Escobar A (1983) The pathology of neurocysticercosis. In: Palacios E, Rodriguez-Carbajal J, Taveras JM (eds) Cysticercosis of the central nervous system. Charles C Thomas, Springfield, pp 27–54Google Scholar
- 12.García HH, Evans CA, Nash TE, Takayanagui OM, White AC Jr, Botero D, Rajshekhar V, Tsang VC, Schantz PM, Allan JC, Flisser A, Correa D, Sarti E, Friedland JS, Martinez SM, Gonzalez AE, Gilman RH, Del Brutto OH (2002) Current consensus guidelines for the treatment of neurocysticercosis. Clin Microbiol Rev 15:747–756CrossRefPubMedPubMedCentralGoogle Scholar
- 21.Prabhakaran V, Drevets DA, Ramajayam G, Manoj JJ, Anderson MP, Oommen A et al (2017) Comparison of monocyte gene expression among patients with neurocysticercosis-associated epilepsy, idiopathic epilepsy and idiopathic headaches in India. PLoS NTD 11(6):e0005664Google Scholar
- 26.Rajshekhar V, Chandy MJ (2000) Incidence of solitary cysticercus granuloma. In: Rajshekhar V, Chandy MJ (eds) Solitary cysticercus granuloma: the disappearing lesion. Orient Longman Ltd, Chennai, pp 12–28Google Scholar
- 28.Rajshekhar V, Oommen A (1997) Serological studies using ELISA and EITB in patients with solitary cysticercus granuloma and seizures. Neurol Inf Epidemiol 2:177–180Google Scholar
- 40.Zammarchi L, Strohmeyer M, Bartalesi F, Bruno E, Muñoz J, Buonfrate D, Nicoletti A, García HH, Pozio E, Bartoloni A, COHEMI Project Study Group (2013) Epidemiology and management of cysticercosis and Taenia solium taeniasis in Europe: systematic review 1990–2011. PLoS One 8:e69537CrossRefPubMedPubMedCentralGoogle Scholar