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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2022; 80(S 05): 296-306
DOI: 10.1590/0004-282X-ANP-2022-S115
DOI: 10.1590/0004-282X-ANP-2022-S115
NEUROINFECTIOUS DISEASE
Update on the diagnosis and management of neurocysticercosis
Atualização no diagnóstico e manejo da neurocisticercose
ABSTRACT
Background: Neurocysticercosis (NCC) is a serious public health problem in several developing countries, including those in Latin America, Asia, and Africa. NCC is considered to be the main cause of late-onset epilepsy in endemic areas. Objective: This review summarizes recent advances in diagnosis and therapy of NCC. Methods: Relevant articles and books were reviewed and used as a source of information for this review. Results: The diagnosis of NCC is based upon neuroimaging studies (MRI and computed tomography) and laboratory analysis of the cerebrospinal fluid (CSF). Praziquantel and albendazole are considered parasiticidal drugs against NCC, but there is an intense debate over the value and safety of these drugs. Conclusion: Given the relative scarcity of clinical trials, more comparative interventional studies, especially randomized controlled trials in long-term clinical evolution, are required in order to clarify the controversy over the validity of parasitic therapy in patients with NCC.
RESUMO
Antecedentes: A neurocisticercose (NCC) é grave problema de saúde pública nos países em desenvolvimento, especialmente na América Latina, Ásia e África. A NCC é considerada a principal causa de epilepsia de início tardio nas regiões endêmicas. Objetivo: Este artigo pretende discutir os recentes avanços no diagnóstico e tratamento da NCC. Métodos: Artigos científicos e livros relevantes serviram de fonte de informação para esta revisão. Resultados: O diagnóstico da NCC é fundamentado nos exames de neuroimagem (ressonância magnética e tomografia computadorizada) e do líquido cefalorraquiano (LCR). Atualmente, praziquantel e albendazole são considerados eficazes na terapêutica etiológica da NCC, mas há intenso debate quanto à validade e segurança desses medicamentos. Conclusão: Pela relativa carência de ensaios clínicos, são necessários novos estudos particularmente randomizados, controlados e com análise de desfechos clínicos a longo prazo para o esclarecimento da polêmica envolvendo a validade da terapêutica parasiticida na NCC.
Keywords:
Cysticercosis - Taenia solium - Epilepsy - Magnetic Resonance Imaging - Cerebrospinal Fluid - Albendazole - PraziquantelPalavras-chave:
Cisticercose - Taenia solium - Epilepsia - Imageamento por Ressonância Magnética - Líquido Cefalorraquiano - Albendazol - PraziquantelAuthors’ contributions:
OMT: wrote the paper; OMT, TMH: revised the paper.
Publication History
Received: 15 March 2022
Accepted: 29 April 2022
Article published online:
06 February 2023
© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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