Neurocysticercosis: Are the Criteria Diagnostic Enough?

Neurocysticercosis (NCC) is a common disease produced by helminths (larval form of Taenia Solium) in the Central Nervous System (CNS). It is one of the common causes of epilepsy in the world. Without aggressive treatment, it continues to be associated with high mortality, with intracranial hypertension, and a lack of seizure control. This chapter reviews several cases of patients with secondary epilepsy who meet the diagnostic criteria for NCC and compares 2001 and 2016 diagnostic criteria: one of the cases with a definitive diagnosis, and the rest with a probable diagnosis. This problem is common for residents of regions where cysticercosis is an endemic zone, like in Mexico. Most patients presented clinical courses and image studies highly suggestive of NCC and positive ELISA testing for cysticerci in CSF. We emphasize the importance of ruling out the differential diagnosis, especially in endemic areas, questioning the use of ELISA in the CSF testing for cysticerci antibodies seems to be not enough, and advise caution when interpreting cystic lesions as having a discernible scolex because potential mimics are not infrequent.