Revised diagnostic criteria for neurocysticercosis

O. H. Del Brutto, T. E. Nash, A. Clinton White, V. Rajshekhar, P. P. Wilkins, G. Singh, C. M. Vasquez, P. Salgado, R. H. Gilman, H. H. Garcia

Research output: Contribution to journalReview article

54 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)202-210
Number of pages9
JournalJournal of the Neurological Sciences
Volume372
DOIs
StatePublished - Jan 15 2017

Fingerprint

Neurocysticercosis
Neuroimaging
Cysts
Cysticercosis
Taenia
Hydrocephalus
Internship and Residency
Parasites
Pathology
Antigens
Drug Therapy
Antibodies

Keywords

  • Cysticercosis
  • Diagnostic criteria, epilepsy, intracranial hypertension
  • Neurocysticercosis
  • Taenia solium

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Del Brutto, O. H., Nash, T. E., White, A. C., Rajshekhar, V., Wilkins, P. P., Singh, G., ... Garcia, H. H. (2017). Revised diagnostic criteria for neurocysticercosis. Journal of the Neurological Sciences, 372, 202-210. https://doi.org/10.1016/j.jns.2016.11.045

Revised diagnostic criteria for neurocysticercosis. / Del Brutto, O. H.; Nash, T. E.; White, A. Clinton; Rajshekhar, V.; Wilkins, P. P.; Singh, G.; Vasquez, C. M.; Salgado, P.; Gilman, R. H.; Garcia, H. H.

In: Journal of the Neurological Sciences, Vol. 372, 15.01.2017, p. 202-210.

Research output: Contribution to journalReview article

Del Brutto, OH, Nash, TE, White, AC, Rajshekhar, V, Wilkins, PP, Singh, G, Vasquez, CM, Salgado, P, Gilman, RH & Garcia, HH 2017, 'Revised diagnostic criteria for neurocysticercosis', Journal of the Neurological Sciences, vol. 372, pp. 202-210. https://doi.org/10.1016/j.jns.2016.11.045
Del Brutto OH, Nash TE, White AC, Rajshekhar V, Wilkins PP, Singh G et al. Revised diagnostic criteria for neurocysticercosis. Journal of the Neurological Sciences. 2017 Jan 15;372:202-210. https://doi.org/10.1016/j.jns.2016.11.045
Del Brutto, O. H. ; Nash, T. E. ; White, A. Clinton ; Rajshekhar, V. ; Wilkins, P. P. ; Singh, G. ; Vasquez, C. M. ; Salgado, P. ; Gilman, R. H. ; Garcia, H. H. / Revised diagnostic criteria for neurocysticercosis. In: Journal of the Neurological Sciences. 2017 ; Vol. 372. pp. 202-210.
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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.",
keywords = "Cysticercosis, Diagnostic criteria, epilepsy, intracranial hypertension, Neurocysticercosis, Taenia solium",
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AU - Del Brutto, O. H.

AU - Nash, T. E.

AU - White, A. Clinton

AU - Rajshekhar, V.

AU - Wilkins, P. P.

AU - Singh, G.

AU - Vasquez, C. M.

AU - Salgado, P.

AU - Gilman, R. H.

AU - Garcia, H. H.

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N2 - 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.

AB - 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.

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KW - Diagnostic criteria, epilepsy, intracranial hypertension

KW - Neurocysticercosis

KW - Taenia solium

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