Neurocisticercosis: Actualizacion en diagnóstico y tratamiento

Cysticercosis occurs when humans become intermediate hosts of Taenia solium after ingesting its eggs. It is the most common helminthic infection of the nervous system, and is endemic in Latin America, Asia and Africa, as well as in industrialized nations with a high immigrant influx of people coming from endemic areas. Neurocysticercosis is a pleomorphic disease due to individual differences in the number and location of the parasites within the nervous system as well as to differences in the severity of the host's immune reaction against the parasite. Common clinical manifestations include epilepsy, focal neurological signs, intracranial hypertension, and cognitive decline. Diagnosis require proper interpretation of clinical, neuroimaging, and serologic data, in the correct epidemiological context. Neuroimaging studies show the parasites as well as the changes they induce in the nervous system. Tests developed to detect anticysticercal antibodies in serum or cerebrospinal fluid present problems inherent to lack of specificity or sensibility, and should not be used by themselves to confirm or exclude the diagnosis. Cysticidal drugs (albendazole and praziquantel) have improved the prognosis of this condition. However, some patients have torpid clinical courses despite therapy. Surgery plays an important role in the management of some forms of the disease, particularly hydrocephalus and intraventricular cysts.