Cerebral signs of focalized infection or tumour with changing localisation or meningoencephalitis with a travel history should alert the clinician to consider the possibility of a worm infection. A detailed history of the stay abroad, of consumption of raw or with animal faeces contaminated food and of known preexisting helminthic disease gives further clues. The diagnostic approach compromises the check for eosinophilia in peripheral blood and CSF, serologic testing and CT scan or MRI examination. Anthelminthic treatment may induce a host reaction with inflammation and deterioration of the clinical picture and has to be performed cautiously and under protection with corticosteroids.