Neurocysticercosis (NCC) is an important disease of the central nervous system caused by infection with Taenia solium metacestodes. In addition to the clinical findings and the imaging analysis, the results of immunological tests are informative for the diagnosis of NCC. To compare the usefulness of serum and cerebrospinal fluid (CSF) samples for antibody detection, paired serum and CSF samples from patients with NCC and other neurological diseases were examined by an enzyme-linked immunosorbent assay with low-molecular-weight antigens purified from T. solium cyst fluid in a blinded fashion. The sensitivity of both serum and CSF samples was 25.0% in inactive NCC cases (n = 4) and 90.9% in active NCC cases (n = 33), and the specificity of serum and CSF was 100% and 95.8%, respectively. When the serum and CSF samples were combined, the sensitivity in active NCC cases became 100%. There was no difference in test performance between serum and CSF samples. Based on these results, we recommend the detection of specific antibodies in serum for the diagnosis of active NCC because of the ease of collection. When the antibody test is negative, however, CSF should be used to confirm NCC and to rule out other medical disorders of the central nervous system. Antibody detection test using only serum or CSF has a limited diagnostic value and cannot be recommended for the diagnosis of suspected inactive NCC cases.

Neurocysticercosis(NCC) is an important disease in central nervous system caused by infectionwith Taenia solium metacestodes. Inaddition to clinical findings and the imaging analysis, the results ofimmunological tests are informative to diagnose NCC. To compare the usefulnessof serum and cerebrospinal fluid (CSF) samples for antibody detection test,paired serum and CSF samples from NCC and other neurological disease patientswere examined by an enzyme-linked immunosorbent assay with low-molecular-weightantigens purified from T. solium cystfluid in a blinded fashion. Sensitivities of both serum and CSF samples were25.0% in inactive NCC cases (n = 4) and 90.9% in active NCC cases (n = 33) and specificitiesof serum and CSF were 100% and 95.8%, respectively. By the combination of serumand CSF samples, sensitivity for active NCC cases became 100%. There was nodifference in the test performance between serum and CSF samples. Based onthese results, we suggest the detection of specific antibodies in serum for thediagnosis of active NCC because of an easy collection of it. However, in caseof the antibody test negative, CSF should be used to confirm NCC and to ruleout other medical disorders of central nerve system. For diagnosis of suspectedinactive NCC cases, antibody detection test using either serum or CSF has alimited diagnostic value and cannot be recommended.