WHO guidelines on management of Taenia solium neurocysticercosis

Taenia solium is a zoonotic tapeworm found globally but with particularly high transmission and hyperendemnicity in parts of Latin America, South and South-East Asia and sub-Saharan Africa. Depending on its life cycle, it causes two distinct presentations in humans: taeniasis and (neuro) cysticercosis. Although people with taeniasis do not have severe disease, they shed T. solium eggs, which can infect both pigs and humans. The resulting larvae form cysts in the muscles, skin, eyes or central nervous system (cysticercosis). “Neurocysticercosis” refers to the development of T. solium cysts in the human central nervous system, which causes focal epilepsy, epileptic seizures, hydrocephalus, chronic headaches, focal deficits and symptoms associated with increased intracranial hypertension.

Neurocysticercosis is one of the leading preventable causes of epilepsy worldwide, estimated to contribute to up to 30% of epilepsy cases in areas where the disease is endemic. The total number of people with symptomatic or asymptomatic neurocysticercosis is estimated to be 2.56–8.30 million, according to the available data on the prevalence of epilepsy. These numbers may, however, be underestimates because of poor access of the groups at highest risk to diagnostic tests. Given this wide range, better understanding of the disease and its control is crucial, as is recognition of the lack of accurate information and the importance of more data on neurocysticercosis epidemiology.