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Human neurocysticercosis, the infection of the nervous system by the larvae of Taenia solium, is a major cause of epileptic seizures and other neurologic morbidity worldwide. The diagnosis and treatment of neurocysticercosis have been considerably improved in recent years. This improvement includes identification and sequencing of specific antigens and development of new assays for laboratory diagnosis, recognition of the frequency and significance of edema around old, calcified cysts (associated to symptomatic episodes), results of a randomized blinded control treatment trial on treatment efficacy for intraparenchymal disease showing a clinical benefit of decreased seizures, and a much better assessment of the frequency and spectrum of cerebrovascular complications. These advances now permit a much better integration of clinical, serologic, and imaging data for diagnosis and therapeutic purposes.
Received April 28, 2004. Accepted for publication April 28, 2004.
Financial support: This work was supported by research grants from the National Institutes of Health (Hector H. Garcia, Theodore E. Nash, Robert H. Gilman), The Wellcome Trust (Robert H. Gilman, Hector H. Garcia), the Food and Drug Administration (Hector H. Garcia, A. Clinton White), and the Bill and Melinda Gates Foundation (Hector H. Garcia, Victor C. W. Tsang, Robert H. Gilman). The American Committee on Clinical Tropical Medicine and Travelers’ Health (ACCTMTH) assisted with publication expenses.
Disclosure: The sponsors had no role in the design or writing of this work.
Authors’ addresses: Hector H. Garcia, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru, Cysticercosis Unit, Instituto de Ciencias Neurologicas, Jr. Ancash 1271, Barrios Altos, Lima 1, Peru, and Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, Telephone: 51-1-328-7360, Fax: 51-1-328-7382, E-mail: hgarcia{at}jhsph.edu. Oscar H. Del Brutto, Department of Neurologic Sciences, Hospital-Clinica Kennedy, Guayaquil, Ecuador. Theodore E. Nash, Laboratory of Parasitic Diseases, Gastrointestinal Parasites Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-6612. A. Clinton White, Jr., Infectious Diseases Section, Department of Medicine, Baylor College of Medicine and Ben Taub General Hospital, Houston, TX 77030. Victor C. W. Tsang, Immunology Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341. Robert H. Gilman, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205.
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