What are the diagnostic criteria for neurocysticercosis (tapeworm infestation)?

Updated: Apr 15, 2021
  • Author: Lisandro Irizarry, MD, MBA, MPH, FACEP; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

To homogenize the diagnosis of neurocysticercosis, revised diagnostic criteria were proposed as follows: [7]

Absolute criteria

  • Histologic demonstration of the parasite from biopsy

  • Direct visualization of subretinal parasite on funduscopic examination

  • Evidence of cystic lesions showing the scolex on CT scan or MRI

Major criteria

  • Lesions highly suggestive of neurocysticercosis on neuroimaging studies (cystic lesions without scolex, ring or nodular enhancing lesion and parenchymal round calcifications)

  • Positive enzyme-linked immunotransfer blot assay (EITB) for the detection of anticysticercal antibodies

  • Spontaneous resolution of small single enhancing lesions

  • Resolution of intracranial cystic lesions after therapy with albendazole or praziquantel

Minor criteria

  • Lesions compatible with neurocysticercosis on neuroimaging studies (CT or MRI showing hydrocephalus, abnormal enhancement of the leptomeninges, and myelograms showing multiple filling defects)

  • Clinical manifestations suggestive of neurocysticercosis (seizures, focal neurological deficits, increased intracranial pressure, intellectual deterioration)

  • Positive CSF ELISA for detection of anticysticercal antibodies or antigen

  • Cysticercosis outside the CNS

Epidemiologic criteria

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

  • History of frequent travel to cysticercosis endemic areas

  • Evidence of a household contact with T solium infection


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