Cysticercosis is a major cause of neurologic disease worldwide that is now increasingly recognized in the United States. Seizures are the most prominent symptom of central nervous system involvement. Current therapeutic interventions include the use of anticonvulsants, surgery, corticosteroids, and antiparasitic drugs, such as albendazole and praziquantel. Although antiparasitic drugs can kill the cysticerci, controlled trials in parenchymal neurocysticercosis have so far failed to document a clear clinical benefit. Further, antiparasitic drugs may actually result in neurologic deterioration in some patients. Therefore, therapy should be individualized based on the location of the cysticerci, the degree of host inflammatory response, the presumed pathogenesis, and the anticipated natural history. The objective of this article is to advance principles and standard approaches for the therapeutic intervention of neurocysticercosis. In addition, we review the pathogenesis and the natural history of cysticercosis, which provide the foundation for the management of its neurologic complications. Copyright (C) 2000 W.B. Saunders Company.