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August 1989


Author Affiliations

Department of Neurology Los Angeles County-University of Southern California Medical Center Los Angeles, CA 90033

Arch Neurol. 1989;46(8):843. doi:10.1001/archneur.1989.00520440023013

In Reply.  —Dr Johnson raises an interesting point concerning eosinophils in cysticercosis. This issue was not specifically addressed in our study. Nevertheless, we have frequently noted cerebrospinal fluid (CSF) eosinophilia, as have many other prior authors.1-3 However, as with any laboratory determination, there are problems of specificity and sensitivity that need to be addressed.Peripheral eosinophilia is of questionable benefit in making the diagnosis of neurocysticercosis. It may be absent despite the presence of meningitis.4 Conversely, its presence may not be helpful because patients frequently have infections with other parasites.5 In contrast, when eosinophils are present in the CSF, it is suggestive of a helminthic infection of the central nervous system. The two parasites most likely to provoke a CSF eosinophilic pleocytosis are either Taenia solium or Angiostrongylus cantonensis.6,7 The prevalence of CSF eosinophilia in neurocysticercosis has varied in a number of studies. In a Romanian series of 65 cases

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