Proposed diagnostic criteria for neurocysticercosis

Oscar H. Del Brutto, V. Rajshekhar, A. Clinton White, V. C. W. Tsang, T. E. Nash, O. M. Takayanagui, P. M. Schantz, C. A. W. Evans, A. Flisser, D. Correa, D. Botero, J. C. Allan, E. Sarti, A. E. Gonzalez, R. H. Gilman, H. H. García

Research output: Contribution to journalArticle

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Abstract

Neurocysticercosis is the most common helminthic infection of the CNS but its diagnosis remains difficult. Clinical manifestations are nonspecific, most neuroimaging findings are not pathognomonic, and some serologic tests have low sensitivity and specificity. The authors provide diagnostic criteria for neurocysticercosis based on objective clinical, imaging, immunologic, and epidemiologic data. These include four categories of criteria stratified on the basis of their diagnostic strength, including the following: 1) absolute - histologic demonstration of the parasite from biopsy of a brain or spinal cord lesion, cystic lesions showing the scolex on CT or MRI, and direct visualization of subretinal parasites by funduscopic examination; 2) major - lesions highly suggestive of neurocysticercosis on neuroimaging studies, positive serum enzyme-linked immunoelectrotransfer blot for the detection of anticysticercal antibodies, resolution of intracranial cystic lesions after therapy with albendazole or praziquantel, and spontaneous resolution of small single enhancing lesions; 3) minor - lesions compatible with neurocysticercosis on neuroimaging studies, clinical manifestations suggestive of neurocysticercosis, positive CSF enzyme-linked immunosorbent assay for detection of anticysticercal antibodies or cysticercal antigens, and cysticercosis outside the CNS; and 4) epidemiologic - evidence of a household contact with Taenia solium infection, individuals coming from or living in an area where cysticercosis is endemic, and history of frequent travel to disease-endemic areas. Interpretation of these criteria permits two degrees of diagnostic certainty: 1) definitive diagnosis, in patients who have one absolute criterion or in those who have two major plus one minor and one epidemiologic criterion; and 2) probable diagnosis, in patients who have one major plus two minor criteria, in those who have one major plus one minor and one epidemiologic criterion, and in those who have three minor plus one epidemiologic criterion.

Original languageEnglish (US)
Pages (from-to)177-183
Number of pages7
JournalNeurology
Volume57
Issue number2
StatePublished - Jul 24 2001
Externally publishedYes

Fingerprint

Neurocysticercosis
Neuroimaging
Cysticercosis
Parasites
Taeniasis
Taenia solium
Praziquantel
Albendazole
Endemic Diseases
Antibodies
Serologic Tests
Spinal Cord
Enzyme-Linked Immunosorbent Assay
Biopsy
Antigens
Sensitivity and Specificity
Brain
Enzymes
Infection
Serum

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Del Brutto, O. H., Rajshekhar, V., White, A. C., W. Tsang, V. C., Nash, T. E., Takayanagui, O. M., ... García, H. H. (2001). Proposed diagnostic criteria for neurocysticercosis. Neurology, 57(2), 177-183.

Proposed diagnostic criteria for neurocysticercosis. / Del Brutto, Oscar H.; Rajshekhar, V.; White, A. Clinton; W. Tsang, V. C.; Nash, T. E.; Takayanagui, O. M.; Schantz, P. M.; W. Evans, C. A.; Flisser, A.; Correa, D.; Botero, D.; Allan, J. C.; Sarti, E.; Gonzalez, A. E.; Gilman, R. H.; García, H. H.

In: Neurology, Vol. 57, No. 2, 24.07.2001, p. 177-183.

Research output: Contribution to journalArticle

Del Brutto, OH, Rajshekhar, V, White, AC, W. Tsang, VC, Nash, TE, Takayanagui, OM, Schantz, PM, W. Evans, CA, Flisser, A, Correa, D, Botero, D, Allan, JC, Sarti, E, Gonzalez, AE, Gilman, RH & García, HH 2001, 'Proposed diagnostic criteria for neurocysticercosis', Neurology, vol. 57, no. 2, pp. 177-183.
Del Brutto OH, Rajshekhar V, White AC, W. Tsang VC, Nash TE, Takayanagui OM et al. Proposed diagnostic criteria for neurocysticercosis. Neurology. 2001 Jul 24;57(2):177-183.
Del Brutto, Oscar H. ; Rajshekhar, V. ; White, A. Clinton ; W. Tsang, V. C. ; Nash, T. E. ; Takayanagui, O. M. ; Schantz, P. M. ; W. Evans, C. A. ; Flisser, A. ; Correa, D. ; Botero, D. ; Allan, J. C. ; Sarti, E. ; Gonzalez, A. E. ; Gilman, R. H. ; García, H. H. / Proposed diagnostic criteria for neurocysticercosis. In: Neurology. 2001 ; Vol. 57, No. 2. pp. 177-183.
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