Treatment Outcome in Patients With Spinal Neurocysticercosis: A Systematic Review of Published Cases and Case Series

Abstract

AbstractBackgroundSpinal neurocysticercosis is a rare central nervous system infection caused by the larval form of theTaenia soliumtapeworm. Due to its rarity, most knowledge is derived from isolated case reports.ObjectivesThis systematic review aims to evaluate existing case reports and observational studies to provide a comprehensive overview of the disease’s clinical presentation, and treatment outcomes.MethodsAdhering to PRISMA guidelines, a search was conducted across multiple databases including PubMed, Scopus, Embase, and Google Scholar. Case reports, case series, and observational studies were included. The review is registered with PROSPERO (CRD42024496957).ResultsThe search yielded 163 records describing 197 patients. Symptoms ranged from one week to over three years, with the most common being paraparesis or quadriparesis (61%) and back pain. Treatment modalities varied. with a combination of surgery and cysticidal drugs being the most preferred (45.2%) treatment. Surgery was done in 77% (152/197) of cases. In 45 % of cases (89/197) cysticidal drugs were given following surgery. Medical treatment alone was given to 22% (43/197) of patients.The majority of cases (92%) irrespective of treatment modality showed clinical improvement. Post-operative complications caused three deaths.ConclusionsWe noted that surgery followed by cysticidal drugs was the most preferred treatment. Medical treatment alone was given to many patients. Clinical improvement was observed in most cases, regardless of the treatment option used. The use of cysticidal drugs could eliminate the need for surgery in many spinal neurocysticercosis patients.Key messageMost spinal neurocysticercosis patients improve clinically with surgery and cysticidal drugs, the most common treatment. Medical management alone also benefits many, suggesting potential to reduce surgical intervention with effective drug therapy.