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Table 111-1

Revised Diagnostic Criteria for Neurocysticercosisa

  1. Absolute criteria
    • Histologic demonstration of the parasite from biopsy of a brain or spinal cord lesion
    • Visualization of subretinal cysticercus
    • Conclusive demonstration of a scolex within a cystic lesion on neuroimaging studies
  2. Neuroimaging criteria
    • Major neuroimaging criteria

      Cystic lesions without a discernible scolex, typical small enhancing lesions, multilobulated cystic lesions in the subarachnoid space, typical parenchymal brain calcifications

    • Confirmative neuroimaging criteria

      Resolution of cystic lesions spontaneously or after cysticidal drug therapy

      Migration of ventricular cysts documented on sequential neuroimaging studies

    • Minor neuroimaging criteria

      Obstructive hydrocephalus or abnormal enhancement of basal leptomeninges

  3. Clinical/exposure criteria
    • Major clinical/exposure criteria

      Detection of specific anticysticercal antibodies (e.g., by enzyme-linked immunoelectrotransfer blot [EITB]) or cysticercal antigens by well-standardized immunodiagnostic tests

      Cysticercosis outside the central nervous system

      Evidence of a household contact with T. solium infection

    • Minor clinical/exposure criteria

      Clinical manifestations suggestive of neurocysticercosis

      Individuals coming from or living in an area where cysticercosis is endemic

a Diagnosis is confirmed by one absolute criterion, by two major criteria or one major and one confirmatory neuroimaging criteria plus any clinical/exposure criterion, or by one major neuroimaging criterion plus two clinical/exposure criteria (including at least one major clinical/exposure criterion), together with the exclusion of other pathologies producing similar neuroimaging findings. A probable diagnosis is supported by one major neuroimaging criterion plus any two clinical/exposure criteria or by one minor neuroimaging criterion plus at least one major clinical/exposure criterion.

Source: Modified from Del Brutto OH et al: Revised diagnostic criteria for neurocysticercosis. J Neurol Sci 372:202, 2017.