Neurocysticercosis

Eradication of cysticercosis is an attainable goal

Neurocysticercosis is a disease of large proportions; in most developing countries, with the exception of the Muslim world, neurocysticercosis is by far the main cause of epilepsy with a late onset and of hydrocephalus in adults.1 In the past 20 years two developments have drastically improved the gloomy picture that was associated with neurocysticercosis in the past: neuroimaging studies and the advent of effective cysticidal drugs. Computed tomography and magnetic resonance are now the cornerstone tools for diagnosing neurocysticercosis, and two drugs, albendazole and praziquantel, are inexpensive, effective cysticidals and are not toxic.2 Pharmacological treatment is now widely accessible and effective even in cases of giant cysticerci or ventricular cysts, which used to be the exclusive domain of neurosurgery.3

However, a new paradox has emerged. Although drug treatment is inexpensive, neuroimaging is unaffordable for many patients in endemic areas. Immunodiagnostic tests using serum, which theoretically would represent a logical alternative for screening and diagnosis, have been abandoned in many neurological centres because of their poor reliability.4 Currently they …