title: Revised diagnostic criteria for neurocysticercosis.
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.
authors.affiliation: School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador.
authors.forename: O H
authors.initials: OH
authors.lastname: Del Brutto
authors.affiliation: Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, United States.
authors.forename: T E
authors.initials: TE
authors.lastname: Nash
authors.affiliation: Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: A C
authors.initials: AC
authors.lastname: White
authors.affiliation: Department of Neurological Sciences, Christian Medical College Hospital, Vellore, India.
authors.forename: V
authors.initials: V
authors.lastname: Rajshekhar
authors.affiliation: Parasitology Services, Marathon, FL, United States.
authors.forename: P P
authors.initials: PP
authors.lastname: Wilkins
authors.affiliation: Department of Neurology, Dayanand Medical College, Ludhiana, India.
authors.forename: G
authors.initials: G
authors.lastname: Singh
authors.affiliation: Department of Neurosurgery, Instituto Nacional de Ciencias Neurológicas, Lima, Peru.
authors.forename: C M
authors.initials: CM
authors.lastname: Vasquez
authors.affiliation: Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico.
authors.forename: P
authors.initials: P
authors.lastname: Salgado
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
authors.forename: R H
authors.initials: RH
authors.lastname: Gilman
authors.affiliation: Center for Global Health, Tumbes, Peru; Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Peru; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru. Electronic address: hgarcia@jhsph.edu.
authors.forename: H H
authors.initials: HH
authors.lastname: Garcia
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging; D006801:Humans; D020019:Neurocysticercosis / Q000175:diagnosis*; D059906:Neuroimaging
keywords: Cysticercosis; Diagnostic criteria, epilepsy, intracranial hypertension; Neurocysticercosis; Taenia solium