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Pediatric Neurocysticercosis Follow-up

  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: Russell W Steele, MD  more...
Updated: Mar 03, 2015

Further Outpatient Care

See the list below:

  • Children who have single nonviable lesions and do not require antihelminthic treatment can be managed safely on an outpatient basis. Most children can be managed as outpatients, especially in the United States where cases are often simple neurocysticercosis.
  • Arrange neurologic follow-up care to manage seizures and any sequelae.
  • Perform a follow-up MRI in 3-6 months or sooner if symptoms worsen or recur.
  • If a child who was admitted for antihelminthic treatment is doing well after 72 hours and follow-up care is assured, the child can be discharged to finish therapy at home.

Further Inpatient Care

See the list below:

  • Indications for admission in patients with neurocysticercosis include the following:
    • Children who need antihelminthic therapy for active or multiple cysts (hospitalize for first 72 h of therapy)
    • Signs of increased intracranial pressure or apparent need for corticosteroid treatment
    • Recalcitrant seizures
    • Hydrocephalus, possibly requiring an intraventricular shunt

Inpatient & Outpatient Medications

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  • Anticonvulsants, with carbamazepine and phenytoin as first-choice treatments
  • Antihelminthics
    • Antihelminthic medication is controversial. Reserve such treatment for certain cases.
    • When antihelminthics are used, albendazole is preferable to praziquantel.


See the list below:

  • Arrange transfer if the facility is unable to provide neurologic or neurosurgical care deemed necessary.


See the list below:

  • Prevention of exposure to infected ova in the home and community is the most effective preventative measure.
  • Examine stools from contacts using 3 consecutive daily specimens. If positive, contacts should receive single doses of praziquantel (10 mg/kg) or albendazole (400 mg).


See the list below:

  • Seizures[35]
  • Death
  • Hydrocephalus
  • Recalcitrant seizure disorder[36]
  • Cerebrovascular accidents
  • Motor and speech delay
  • Blindness
  • Dementia


See the list below:

  • In cases with single lesions, prognosis is excellent. In those with multiple lesions, especially extraparenchymal, prognosis can be poor.
  • Treatment with antihelminthics results in complete resolution or significant regression in 80-90% of patients. Most children with calcified single lesions that do not require antihelminthic treatment have spontaneous resolution in 2-9 months, usually within 3 months.
  • Usually, seizures are easy to control, and most children can be weaned from their anticonvulsants within 1-2 years. Most children remain free of seizures.

Patient Education

See the list below:

  • Educate patients and their families regarding prevention.
  • Emphasize improvement in sanitation, separation of pigs from humans, and food preparation hygiene in endemic areas.
  • For excellent patient education resources, please see eMedicineHealth's Infections Center.
Contributor Information and Disclosures

Vinod K Dhawan, MD, FACP, FRCPC, FIDSA Professor, Department of Clinical Medicine, University of California, Los Angeles, David Geffen School of Medicine; Chief, Division of Infectious Diseases, Rancho Los Amigos National Rehabilitation Center

Vinod K Dhawan, MD, FACP, FRCPC, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, Royal College of Physicians and Surgeons of Canada

Disclosure: Received honoraria from Pfizer Inc for speaking and teaching.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Ashir Kumar, MD, MBBS FAAP, Professor Emeritus, Department of Pediatrics and Human Development, Michigan State University College of Human Medicine

Ashir Kumar, MD, MBBS is a member of the following medical societies: Infectious Diseases Society of America, American Association of Physicians of Indian Origin

Disclosure: Nothing to disclose.


Leslie L Barton, MD Professor Emerita of Pediatrics, University of Arizona College of Medicine

Leslie L Barton, MD is a member of the following medical societies: American Academy of Pediatrics, Association of Pediatric Program Directors, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose. Eric HW Kossoff, MD Assistant Professor, Departments of Pediatrics and Neurology, Associate Director of Pediatric Neurology Residency Program, Johns Hopkins School of Medicine

Eric HW Kossoff, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Pediatrics, American Epilepsy Society, and Child Neurology Society

Disclosure: Nothing to disclose.

  1. Prasad KN, Prasad A, Verma A, Singh AK. Human cysticercosis and Indian scenario: a review. J Biosci. 2008 Nov. 33(4):571-82. [Medline].

  2. Serpa JA, Yancey LS, White AC Jr. Advances in the diagnosis and management of neurocysticercosis. Expert Rev Anti Infect Ther. 2006 Dec. 4(6):1051-61. [Medline].

  3. Shandera WX, Kass JS. Neurocysticercosis: current knowledge and advances. Curr Neurol Neurosci Rep. 2006 Nov. 6(6):453-9. [Medline].

  4. Singhi P, Singhi S. Neurocysticercosis in children. J Child Neurol. 2004 Jul. 19(7):482-92. [Medline].

  5. Sinha S, Sharma BS. Neurocysticercosis: A review of current status and management. J Clin Neurosci. 2009 Apr 24. [Medline].

  6. Singhi P. Neurocysticercosis. Ther Adv Neurol Disord. 2011 Mar. 4(2):67-81. [Medline]. [Full Text].

  7. Serpa JA, Graviss EA, Kass JS, White AC Jr. Neurocysticercosis in Houston, Texas: an update. Medicine (Baltimore). 2011 Jan. 90(1):81-6. [Medline].

  8. Sorvillo F, Wilkins P, Shafir S, Eberhard M. Public health implications of cysticercosis acquired in the United States. Emerg Infect Dis. 2011 Jan. 17(1):1-6. [Medline].

  9. Zee CS, Go JL, Kim PE, DiGiorgio CM. Imaging of neurocysticercosis. Neuroimaging Clin N Am. 2000 May. 10(2):391-407. [Medline].

  10. Wallin MT, Kurtzke JF. Neurocysticercosis in the United States: review of an important emerging infection. Neurology. 2004 Nov 9. 63(9):1559-64. [Medline].

  11. Garcia HH, Del Brutto OH,. Neurocysticercosis: updated concepts about an old disease. Lancet Neurol. 2005 Oct. 4(10):653-61. [Medline].

  12. Chaoshuang L, Zhixin Z, Xiaohong W, Zhanlian H, Zhiliang G. Clinical analysis of 52 cases of neurocysticercosis. Trop Doct. 2008 Jul. 38(3):192-4. [Medline].

  13. Jung H, Cardenas G, Sciutto E, Fleury A. Medical treatment for neurocysticercosis: drugs, indications and perspectives. Curr Top Med Chem. 2008. 8(5):424-33. [Medline].

  14. Ruiz-Garcia M, Gonzalez-Astiazaran A, Rueda-Franco F. Neurocysticercosis in children. Clinical experience in 122 patients. Childs Nerv Syst. 1997 Nov-Dec. 13(11-12):608-12. [Medline].

  15. Talukdar B, Saxena A, Popli VK. Neurocysticercosis in children: clinical characteristics and outcome. Ann Trop Paediatr. 2002 Dec. 22(4):333-9. [Medline].

  16. Carabin H, Ndimubanzi PC, Budke CM, Nguyen H, Qian Y, Cowan LD, et al. Clinical manifestations associated with neurocysticercosis: a systematic review. PLoS Negl Trop Dis. 2011 May. 5(5):e1152. [Medline]. [Full Text].

  17. Rosenfeld EA, Byrd SE, Shulman ST. Neurocysticercosis among children in Chicago. Clin Infect Dis. 1996 Aug. 23(2):262-8. [Medline].

  18. Michelet L, Fleury A, Sciutto E, Kendjo E, Fragoso G, Paris L, et al. Human neurocysticercosis: comparison of different diagnostic tests using cerebrospinal fluid. J Clin Microbiol. 2011 Jan. 49(1):195-200. [Medline]. [Full Text].

  19. Garg RK, Sinha MK. Multiple ring-enhancing lesions of the brain. J Postgrad Med. 2010 Oct-Dec. 56(4):307-16. [Medline].

  20. Fleury A, Hernandez M, Avila M, et al. Detection of HP10 antigen in serum for diagnosis and follow-up of subarachnoidal and intraventricular human neurocysticercosis. J Neurol Neurosurg Psychiatry. 2007 Sep. 78(9):970-4. [Medline].

  21. Almeida CR, Ojopi EP, Nunes CM, et al. Taenia solium DNA is present in the cerebrospinal fluid of neurocysticercosis patients and can be used for diagnosis. Eur Arch Psychiatry Clin Neurosci. 2006 Aug. 256(5):307-10. [Medline].

  22. Rodriguez S, Dorny P, Tsang VC, Pretell EJ, Brandt J, Lescano AG. Detection of Taenia solium antigens and anti-T. solium antibodies in paired serum and cerebrospinal fluid samples from patients with intraparenchymal or extraparenchymal neurocysticercosis. J Infect Dis. 2009 May 1. 199(9):1345-52. [Medline].

  23. Balaji J, D M. Clinical and Radiological Profile of Neurocysticercosis in South Indian Children. Indian J Pediatr. 2011 Mar 12. [Medline].

  24. Figueroa JJ, Davis LE, Magalhaes A. Extraparenchymal neurocysticercosis in albuquerque, New Mexico. J Neuroimaging. 2011 Jan. 21(1):38-43. [Medline].

  25. Odermatt P, Preux PM, Druet-Cabanac M. Treatment of neurocysticercosis: a randomised controlled trial. J Neurol Neurosurg Psychiatry. 2008 Sep. 79(9):978. [Medline].

  26. Thussu A, Chattopadhyay A, Sawhney IM, Khandelwal N. Albendazole therapy for single small enhancing CT lesions (SSECTL) in the brain in epilepsy. J Neurol Neurosurg Psychiatry. 2008 Mar. 79(3):272-5. [Medline].

  27. Carpio A, Kelvin EA, Bagiella E, Leslie D, Leon P, Andrews H. Effects of albendazole treatment on neurocysticercosis: a randomised controlled trial. J Neurol Neurosurg Psychiatry. 2008 Sep. 79(9):1050-5. [Medline].

  28. Ramirez-Zamora A, Alarcon T. Management of neurocysticercosis. Neurol Res. 2010 Apr. 32(3):229-37. [Medline].

  29. Abba K, Ramaratnam S, Ranganathan LN. Anthelmintics for people with neurocysticercosis. Cochrane Database Syst Rev. 2010 Jan 20. CD000215. [Medline].

  30. Garcia HH, Gonzales I, Lescano AG, Bustos JA, Zimic M, Escalante D, et al. Efficacy of combined antiparasitic therapy with praziquantel and albendazole for neurocysticercosis: a double-blind, randomised controlled trial. Lancet Infect Dis. 2014 Aug. 14(8):687-95. [Medline]. [Full Text].

  31. Del Brutto OH, Roos KL, Coffey CS, García HH. Meta-analysis: Cysticidal drugs for neurocysticercosis: albendazole and praziquantel. Ann Intern Med. 2006 Jul 4. 145(1):43-51. [Medline].

  32. Kaur S, Singhi P, Singhi S, Khandelwal N. Combination therapy with albendazole and praziquantel versus albendazole alone in children with seizures and single lesion neurocysticercosis: a randomized, placebo-controlled double blind trial. Pediatr Infect Dis J. 2009 May. 28(5):403-6. [Medline].

  33. Matthaiou DK, Panos G, Adamidi ES, Falagas ME. Albendazole versus praziquantel in the treatment of neurocysticercosis: a meta-analysis of comparative trials. PLoS Negl Trop Dis. 2008 Mar 12. 2(3):e194. [Medline]. [Full Text].

  34. Rajshekhar V. Surgical management of neurocysticercosis. Int J Surg. 2010. 8(2):100-4. [Medline].

  35. Kelvin EA, Carpio A, Bagiella E, Leslie D, Leon P, Andrews H, et al. Seizure in people with newly diagnosed active or transitional neurocysticercosis. Seizure. 2011 Mar. 20(2):119-25. [Medline]. [Full Text].

  36. Viola GM, White AC Jr, Serpa JA. Hemorrhagic cerebrovascular events and neurocysticercosis: a case report and review of the literature. Am J Trop Med Hyg. 2011 Mar. 84(3):402-5. [Medline]. [Full Text].

  37. Li J, Zhang WB, Wilson M, et al. A novel recombinant antigen for immunodiagnosis of human cystic echinococcosis. J Infect Dis. 2003 Dec 15. 188(12):1952-61. [Medline].

Case 1: Coronal image MRI of a 6-year-old boy from Peru with single right frontal cyst.
Case 1: Axial image MRI of a 6-year-old boy from Peru with single right frontal cyst.
Case 2: MRI of a 40-year-old patient with a single parietal calcified cyst.
Case 2: CT scan of a 40-year-old patient with a single parietal calcified cyst.
Case 3: MRI of a 47-year-old man with 2 right parietal cysts, one with edema.
Case 3: MRI of a 47-year-old man with 2 right parietal cysts, one with edema, after the larger cyst had involuted.
Case 4: CT scan of 28-year-old woman with occipital headaches and diplopia; imaging reveals a superior cerebellar cyst, mild ventricular dilatation, and old calcifications in the right insular region. Image courtesy of Gholam Motamedi, MD.
Case 4: MRI of 28-year-old woman with occipital headaches and diplopia; MRI discerns prepontine and suprasellar lesions, as well as the superior cerebellar cyst. Image courtesy of Gholam Motamedi, MD.
MRI of multiple cysts. Image courtesy of the Centers for Disease Control and Prevention.
MRI of an 87-year-old patient from Europe with bitemporal lesions found incidentally. Image courtesy of Jon Poling, MD.
Two parietal lesions observed on autopsy specimen.
MRI of a 40-year-old woman with severe epilepsy and a left temporal single cyst.
MRI of a 21-year-old woman with left temporal lobe epilepsy and a single cyst.
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