Neurocysticercosis: Five new things.

Neurocysticercosis is the most common parasitic brain disease worldwide. Its clinical heterogeneity is related to localization, number and stage of evolution of the parasites, sex, age, and intensity of the host brain inflammatory reaction. In addition to the localization of the parasite, inflammation is the main phenomenon responsible of symptomatology. Acute symptomatic seizures are the most common symptom in patients with parenchymal parasites, but most do not evolve into epilepsy. Neurocysticercosis diagnosis is based mainly on neuroimaging. New imaging techniques have improved detection of the scolex and visualization of cysts in the extraparenchymal spaces. Immunologic testing can be useful, particularly when imaging is equivocal. Based on disappearance of parasites, antihelminthic drugs as currently used are effective in approximately one-third of patients with parenchymal viable cysts.