noelectrotransfer blot is nearly 100% specific and highly sensitive in detecting NCC.

CT and MRI represent the most accurate imaging modalities available. CT is particularly beneficial in identifying parenchymal calcifications that occur in 65% of patients with NCC. Calcification is encountered more often in adults. In children, a diffuse, homogeneously enhancing lesion is more likely to be seen. Twenty-five percent of patients develop parenchymal or intraventricular cysts that are usually evident on CT and greater than 40% will have hydrocephalus. Intraventricular cysts are more readily seen in the presence of intra-ventricular contrast. Acute parenchymal NCC usually appears as a hypodense area that enhances following contrast administration. Large cystic lesions may show evidence of ringenhancement. MRI, is also quite accurate in identifying lesions of NCC, and may be more sensitive for identifying intraventricular lesions than non-contrasted CT [26,27].

Treatment of NCC includes administration of anti-helminthic drugs and surgery in selected cases. Praziquantal is highly effective against cysticercosis [26]. The drug is well tolerated, the major side effect occurring from the intense inflammatory reaction produced by the dying parasite. Consequently, for patients with severe NCC, it has been recommended that praziquan-tal be given in conjunction with corticosteroids. The efficacy of praziquantal has undoubtedly altered the role of surgery in NCC. Indeed, 90% of patients with parenchymal lesions have a non-progressive course and can be successfully managed using praziquantal, corticosteroids and anti-epileptic agents to prevent or control seizures [27]. Nonetheless, there remain several indications for surgery. Occasionally, the diagnosis of NCC is unclear and diagnostic biopsy is necessary. Ventriculo-peritoneal shunting is necessary for patients with hydrocephalus, especially when related to racemose meningob-asal disease, since CSF diversion is far safer than attempting to deal directly with the basal cysts. Surgical excision of large symptomatic space-occupying cysts is sometimes indicated. In fact, the best outcomes occur in this setting, with 75% of patients improved. In contrast, the poorest results are seen with basal meningeal disease, where improvement occurs in only 28% and the mortality rate is 67%. Finally, surgery is indicated for patients with intraventricular cysts

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