Movement Disorders in Neurocysticercosis: A Systematic Review.

Background: Neurocysticercosis, caused by larvae, is a common parasitic infection of the central nervous system in endemic regions. Although seizures and headaches are the typical presentations, movement disorders represent a lesser-known but clinically important manifestation. This systematic review aimed to examine the spectrum, radiological correlates, treatments, and outcomes of movement disorders associated with neurocysticercosis.

Methods: A comprehensive search of PubMed, Scopus, Embase, Web of Science, and Google Scholar was conducted to identify case reports, case series, and cohort studies reporting movement disorders in confirmed cases of neurocysticercosis. Included studies were assessed for clinical details, neuroimaging findings, cerebrospinal fluid results, type of movement disorder, treatment regimens, and outcomes. Quality assessment was done using Murad's framework for case reports.

Results: A total of 45 patients were included: 21 presented with hypokinetic and 24 with hyperkinetic movement disorders. In the hypokinetic group, parkinsonism was the most common manifestation (52.38%) with basal ganglia and midbrain involvement. Levodopa was administered in 28.57%, and 47.62% achieved marked clinical improvement. In the hyperkinetic group, chorea (29.17%), facial dyskinesias (25%), and myoclonus (16.67%) were prevalent. Albendazole with corticosteroids was used in over 60% of cases, and 83.3% had full or marked recovery.

Conclusions: Movement disorders in neurocysticercosis are diverse but potentially reversible. Early neuroimaging and targeted therapy yield favorable outcomes, especially in hyperkinetic presentations.