Neurocysticercosis
Page most recently updated 7 September 2026
This page focuses on the reported psychiatric associations, which may be the initial presenting manifestation, and on other clinical features that may assist the psychiatrist or primary care physician in identifying the underlying diagnosis, considered through the lenses of the diagnostic lenses framework.
Neurocysticercosis is a CNS manifestation of infection with the larval form of Taenia solium (the pork tapeworm), in which cysts develop within the central nervous system. A distinctive presentation may include new-onset seizures and neuropsychiatric symptoms, particularly when accompanied by focal sensorimotor deficits or features of raised intracranial pressure such as headache, vomiting, or visual disturbance.
Exposure clues may include residence in or prolonged travel to regions where T. solium is endemic, particularly parts of Latin America, South and Southeast Asia, and sub-Saharan Africa, as well as close contact with a person with intestinal T. solium infection. Importantly, infection can occur through ingestion of T. solium eggs from human faecal contamination and does not require the person to have eaten pork.
It can present with psychiatric features such as depression, cognitive impairment, personality or behavioural change, and, less commonly, psychosis. Psychiatric symptoms may occur alongside neurological manifestations or, occasionally, may be the presenting feature.
Other characteristic features include seizures or epilepsy (the most common neurological manifestation), headache, focal neurological deficits, cognitive impairment, and features of raised intracranial pressure such as vomiting, visual disturbance, and papilloedema. Depending on the location of the cysts, neurocysticercosis may also cause hydrocephalus, chronic meningitis, cranial neuropathies, ataxia, or stroke-like presentations. Extraparenchymal disease, particularly subarachnoid or ventricular disease, is more likely to produce hydrocephalus, meningitis, and raised intracranial pressure.
From a multisystemic lens perspective, clinical features in other body systems include (but are not limited to):
Cardiovascular: Cardiac cysticercosis is usually asymptomatic but may rarely cause arrhythmias, conduction abnormalities, pericardial effusion, or myocarditis.
Dermatologic: Subcutaneous cysticercosis may present as firm, usually painless nodules and can provide a useful clue to disseminated cysticercosis.
Early diagnosis is important to identify active, potentially treatable infection, distinguish active cysts from inactive calcified lesions, prevent or manage seizures and raised intracranial pressure, and reduce the risk of neurological disability and other serious complications.
Selected references and further reading — Multisystemic lens
Cardinal RN, Bullmore ET. The diagnosis of psychosis. Cambridge: Cambridge University Press; 2011.
Sachdev PS, Keshavan MS, editors. Secondary schizophrenia. Cambridge: Cambridge University Press; 2010.
Levenson JL, editor. The American Psychiatric Association Publishing textbook of psychosomatic medicine and consultation-liaison psychiatry. 3rd ed. Washington (DC): American Psychiatric Association Publishing; 2019.
Stern TA, Beach SR, Smith FA, Freudenreich O, Vranceau AM, Fava M, editors. Massachusetts General Hospital handbook of general hospital psychiatry. 8th ed. Philadelphia: Elsevier; 2025.
Arciniegas DB, Yudofsky SC, Hales RE, editors. The American Psychiatric Association Publishing textbook of neuropsychiatry and clinical neurosciences. 6th ed. Washington (DC): American Psychiatric Association Publishing; 2018.
Agrawal N, Faruqui R, Bodani M, editors. Oxford textbook of neuropsychiatry. Oxford: Oxford University Press; 2020.
Boland R, Verduin M, editors. Kaplan and Sadock's comprehensive textbook of psychiatry. 11th ed. Philadelphia: Wolters Kluwer; 2024.
Loscalzo J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Harrison's principles of internal medicine. 22nd ed. New York: McGraw Hill; 2025.