A Narrative Review of the Neurological Manifestations Associated with Echinococcosis

Echinococcosis, caused by the larval stages of the tapeworms of the genus Echinococcus, remains a significant public health concern globally, particularly in regions where livestock farming and poor hygiene practices prevail. While hepatic and pulmonary involvement are most commonly reported, echinococcosis can also affect the central nervous system (CNS), leading to various neurological manifestations. This narrative review aims to provide a comprehensive overview of the neurological manifestations associated with echinococcosis, including pathogenesis, clinical presentation, diagnostic modalities, and management strategies. Furthermore, the review discusses the mechanisms of CNS invasion by Echinococcus species, highlighting the parasite’s ability to infiltrate neural tissue and form cystic lesions within the brain and spinal cord. Clinical presentation varies widely and may include focal neurological deficits, seizures, raised intracranial pressure, and spinal cord compression, among others. Diagnostic evaluation relies on a combination of imaging studies, serological tests, and, in some cases, histopathological examination of cystic fluid or tissue specimens. We explore the diverse spectrum of CNS involvement, from intracranial to spinal cord lesions, and discuss the challenges in diagnosis and treatment. By synthesizing current literature and clinical evidence, this review emphasizes the importance of early recognition and multidisciplinary management approaches in improving outcomes for patients with neuro-echinococcosis.