Neurocysticercosis in the Tropics (and Beyond)

Purpose of Review: Human cysticercosis is caused by ingestion of Taeniasolium eggs from asymptomatic taenia carriers and not by eating undercooked pork. Neurocysticercosis (NCC), a disease caused by the invasion of the CNS and its coverings by the larval stage of Taenia solium, has trespassed the boundaries of tropical regions and is the most common helminthic infection of the CNS worldwide. Here, recent advances in the diagnosis and management of NCC are discussed with attention to the introduction of modern neuroimaging techniques, sophisticated immune diagnostic tests, and studies focusing on the usefulness of cysticidal drugs. Recent Findings: The most recent revision of the unified chart of diagnostic criteria for NCC will facilitate its diagnosis in different settings by providing easier operational definitions. From this chart, it is clear that neuroimaging studies are fundamental for NCC diagnosis, inasmuch as immunological test and clinical manifestations only provide circumstantial evidence of CNS infection. Recent studies provided level 1 evidence favoring the use of cysticidal drugs for therapy of patients with parenchymal NCC by showing disappearance of brain lesions and clinical improvement in most cases. Summary: Despite recent advances, the last word on diagnosis and management of NCC has not been said. Further validation of the revised chart of diagnostic criteria is desirable to assess its reliability in different scenarios. Also, randomized controlled trials for patients with subarachnoid, ventricular, and spinal NCC are urgently needed to increase the level of evidence supporting the different therapeutic approaches suggested for these forms of the disease.