Title
Revised diagnostic criteria for neurocysticercosis
Date Issued
15 January 2017
Access level
open access
Resource Type
review
Author(s)
University of Texas Medical Branch
Johns Hopkins Bloomberg School of Public Health
Publisher(s)
Elsevier B.V.
Abstract
Background A unified set of criteria for neurocysticercosis (NCC) has helped to standardize its diagnosis in different settings. Methods Cysticercosis experts were convened to update current diagnostic criteria for NCC according to two principles: neuroimaging studies are essential for diagnosis, and all other information provides indirect evidence favoring the diagnosis. Recent diagnostic advances were incorporated to this revised set. Results This revised set is structured in absolute, neuroimaging and clinical/exposure criteria. Absolute criteria include: histological confirmation of parasites, evidence of subretinal cysts, and demonstration of the scolex within a cyst. Neuroimaging criteria are categorized as major (cystic lesions without scolex, enhancing lesions, multilobulated cysts, and calcifications), confirmative (resolution of cysts after cysticidal drug therapy, spontaneous resolution of single enhancing lesions, and migrating ventricular cysts on sequential neuroimaging studies) and minor (hydrocephalus and leptomeningeal enhancement). Clinical/exposure criteria include: detection of anticysticercal antibodies or cysticercal antigens by well-standardized tests, systemic cysticercosis, evidence of a household Taenia carrier, suggestive clinical manifestations, and residency in endemic areas. Besides patients having absolute criteria, definitive diagnosis can be made in those having two major neuroimaging criteria (or one major plus one confirmative criteria) plus exposure. For patients presenting with one major and one minor neuroimaging criteria plus exposure, definitive diagnosis of NCC requires the exclusion of confounding pathologies. Probable diagnosis is reserved for individuals presenting with one neuroimaging criteria plus strong evidence of exposure. Conclusions This revised set of diagnostic criteria provides simpler definitions and may facilitate its more uniform and widespread applicability in different scenarios.
Start page
202
End page
210
Volume
372
Language
English
OCDE Knowledge area
Neurología clínica Parasitología
Scopus EID
2-s2.0-84999873144
PubMed ID
Source
Journal of the Neurological Sciences
ISSN of the container
0022510X
Sponsor(s)
Dr. Del Brutto is supported by Universidad Espíritu Santo, Guayaquil – Ecuador ; Dr. Nash reports no disclosures; Dr. White receives royalties for chapters on cysticercosis from UpToDate; Dr. Rajshekhar, Dr. Wilkins, Dr. Singh, Dr. Vasquez, Dr. Salgado and Dr. Gilman report no disclosures, and Dr. Garcia is supported by a Wellcome Trust International Senior Fellowship in Public Health and Tropical Medicine and is funded by FIC NIH Training Grant TW001140 and NINDS U01 NS086974 . Fogarty International Center D43TW001140 National Institute of Allergy and Infectious Diseases ZIAAI000846
Sources of information: Directorio de Producción Científica Scopus