**5. Diagnosis**

The diagnosis of hydrocephalus related to NCC involves a combination of clinical evaluation, neuroimaging, and CSF analysis. Neuroimaging studies, such as computed tomCT or MRI [48–50], are crucial in identifying the presence of hydrocephalus, assessing the location and extent of cysts, and evaluating the ventricular system. CSF analysis may rule out other causes of hydrocephalus and assess for signs of inflammation or infection [7, 39–41, 51].

The focus should be primarily on the laboratory diagnosis of NCC, an infectious disease affecting the nervous system and an important cause of epilepsy in developing countries. The primary immunodiagnostic approach involves assessing whether serological findings are compatible with the diagnosis suggested by imaging results. Lentil lectin-purified parasite antigens are used in enzyme-linked immunoelectrotransfer blot format to detect antibodies, while monoclonal antibody-based enzyme-linked immunosorbent assays (ELISAs) are used for antigen detection [52, 53]. The article also highlights recent developments in assay configurations that show promise in simultaneous antibody and antigen detection. However, it is important to note that the usefulness of immunodiagnostic tests is limited in areas endemic for NCC where confirmatory brain imaging may not be possible. This is because the tests available for immunodiagnosis will not significantly impact the clinical management of most individuals with asymptomatic or symptomatic NCC [9, 52–54].
