Treatment outcome in patients with spinal neurocysticercosis: a systematic review of published cases and case series.

Abstract

Aims: Spinal neurocysticercosis is a rare central nervous system infection caused by the larval form of the Taenia solium. Due to its rarity, most knowledge is derived from isolated case reports. This review aims to evaluate existing case reports and observational studies to provide a comprehensive overview of the disease's clinical presentation and treatment outcomes.

Methods: Following PRISMA guidelines, a comprehensive search was performed across various databases. The review included case reports, case series, and observational studies, and it is registered with PROSPERO (CRD42024496957).

Results: This review analyzed 206 spinal neurocysticercosis cases (from 171 published reports). Symptoms persisted for one week to six months in 49% of cases, and common presentations included paraparesis/quadriparesis (61.7%) and neck/limb/back pain (40.8%). CSF abnormalities were observed in 23.8%. Thoracic involvement was most frequent (39.3%), followed by cervical (27.2%). Neurocysticercosis lesions in other regions, primarily the brain, were found in 18.9%. Differential diagnoses included spinal cord tumors (13.1%). Treatment often involved surgery alone (32%) or with cysticidal drugs (45.6%), with a 91.3% improvement rate, indicating favorable outcomes.

Conclusions: Spinal neurocysticercosis primarily affects the thoracic and cervical regions. Most patients respond well to medical therapy; surgery is mainly for progressive neurological deficits.