Diagnosis of Neurocysticercosis by Computed Tomography: How Much More Do Magnetic Resonance Imaging and Serology, in addition, Contribute?

Abstract

Background: In the developing world the leading cause of seizures and epilepsy is neurocysticercosis caused by the larvae of Taenia solium . Neurocysticercosis is diagnosed by Computed Tomography (CT), Magnetic Resonance Imaging (MRI) or by serological tests on serum or cerebro spinal fluid. We evaluated the role of conventional MRI and serum anti bodies to cysticercal vasicular fluid antigen in patients with seizures diagnosed as neurocysticercosis by CT. Methods: Plain and gadolinium-enhanced MRI of brain in 51 patients, and ELISA to detect IgG antibodies in the serum to cysticercal vesicular fluid antigen in 44 patients, were performed. Results: The lesions observed were predominantly Single enhancing CT lesions (SECTL) in 36(70.5%) of the 51 patients studied; they were confined to the brain parenchyma in 50(98%) of the patients. There was no statistically significant difference in the number of lesions detected by CT or MRI in the brain parenchyma. IgG antibodies to cysticercal antigen could be detected in 11(24.8%) of the 44 patients tested by ELISA. Conclusion:In the patient population studied, MRI did not contribute much in the diagnosis of neurocysticercosis over CT in terms of number of lesions detected. Serology was found to be useful in the diagnosis of neurocysticercosis in only about a quarter of patients diagnosed by imaging modalities.