Objective:

To examine published literature on neurocysticercosis in India, with a focus on neurological symptoms, diagnostic approaches, and clinical management outcomes.

Background:

Neurocysticercosis (NCC), caused by larval infection of the parasite Taenia solium, represents a significant endemic public health burden in India. Current understanding of clinical patterns, diagnostic approaches, and treatment outcomes is fragmented across case reports and heterogeneous institutional studies. This review synthesizes the published literature to provide comprehensive insights into NCC patient management in India.

Design/Methods:

A PubMed and CINAHL-based systematic literature search on NCC in India identified 84 English-language articles involving human subjects and published between 2000 and 2025. Data on patient demographics, symptoms, clinical presentation, lesion characteristics, diagnostic methods, treatment modalities (e.g., antiparasitic therapies, antiepileptics, surgical interventions), and reported outcomes were extracted.

Results:

Seizures were the predominant presentation (n=52), followed by headaches and focal deficits. Solitary cysticercus granulomas were frequently reported (n=38), particularly among children and young adults in North India, while disseminated and intraventricular forms indicated more severe disease progression. Diagnostic approaches demonstrated a transition from CT to MRI usage. Serological testing had variable sensitivity (40 to 85%). Treatment patterns also shifted toward combination antiparasitic therapy (e.g., albendazole with or without praziquantel) alongside corticosteroids and antiepileptics. Pediatric studies (n=15) demonstrated favorable seizure control (>80%) with albendazole therapy in single enhancing lesions. Endoscopic surgical interventions were necessary for some complicated cases. Socioeconomic factors, such as poor sanitation and pig-farming practices, were consistently correlated with higher disease burden.

Conclusions:

NCC remains a major neurological illness in India with heterogeneous clinical outcomes. Early neuroimaging, administration of appropriate antiparasitic therapy, and seizure management are critical for optimized outcomes. Future directions should include establishment of multi-center treatment registries, promotion of standardized treatment protocols, and refining of community-based prevention strategies to address transmission through improved sanitation and veterinary interventions.