Immunological Tests

Tests directed to the detection of anticysticercal antibodies in serum and CSF are a valuable complement to neuroimaging in the evaluation of patients with suspected NCC, but they should never be used alone to exclude or confirm the diagnosis of the disease.28 From the many tests performed in serum, current data indicate that the most effective is the enzyme-linked immunoelectrotransfer blot (EITB). Such assay has been claimed to have 100% specificity and 98% sensitivity.37 However the serum EITB may give positive results in patients with taeniasis or in those who have

Image Brain Enhancement
Figure 3. Neuroimaging findings in subarachnoid neurocysticercosis: A) CT showing hydrocephalus; and B) Contrast-enhanced CT showing subarachnoid cysts and abnormal enhancement of leptomeninges at the base of the brain.

cysticerci lodged outside the nervous system (false positive results). In addition, the sensitivity of EITB is low in patients with a single intracranial cysticercus (false negative results).38 Another widely used test is the enzyme-linked immunosorbent assay (ELISA). The reliability of this test in CSF is higher than that performed in serum; however, its accuracy depends on the viability of cysticerci and their location within the nervous system. The ELISA is highly sensitive in cases of active subarach-noid NCC. Such sensitivity decreases considerably when the lesions are calcified or when viable parenchymal cysts are not in contact with the brain parenchyma.39,40

Figure 4. Tl-weighted MRI showing asymmetric hydrocephalus in a patient with a lateral ventricle cysticer-cus.

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