Diagnostic criteria for neurocysticercosis – Table B

Absolute criteria

Histological 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 study

Neuroimaging criteria

Major criteria:

Cystic lesion(s)* with no discernible scolex

Enhancing lesion(s)^¶

Multilobulated cystic lesion(s) in the subarachnoid space.

Typical parenchymal brain calcification(s)^Δ

Confirmation criteria:

Resolution of cystic lesions after cysticidal drug therapy

Spontaneous resolution of single small enhancing lesions^◊

Migration of ventricular cysts documented on sequential neuroimaging studies^§

Minor criteria:

Obstructive hydrocephalus or abnormal enhancement of basal leptomeninges

Clinical/epidemiologic exposure criteria

Major criteria:

Detection of specific anticysticercal antibodies or cysticercal antigens by well-standardized immunodiagnostic tests^¥

Cysticercosis outside the central nervous system^‡

Household contact with Taenia solium infection

Minor criteria:

Clinical manifestations suggestive of neurocysticercosis^†

Individuals with prior or current residence in an area where cysticercosis is endemic**

CSF: cerebrospinal fluid; CT: computed tomography; MRI: magnetic resonance imaging.
* Cystic lesions: Rounded, well-defined lesions with liquid contents of signal similar to that of CSF on CT or MRI.
¶ Enhancing lesion(s): Ring- or nodular-enhancing lesion(s) of 10 to 20 mm in diameter, with or without surrounding edema; not displacing midline structures.
Δ Typical parenchymal brain calcification(s): Solid lesion(s), most usually <10 mm in diameter.
◊ Use of corticosteroids makes this criterion invalid.
§ Migration of ventricular cyst: Demonstration of a different location of ventricular cystic lesions on sequential CTs or MRIs.
¥ Well-standardized immunodiagnostic tests: Antibody detection by enzyme-linked immuno-electrotransfer blot assay using lentil lectin-purified T. solium nantigens and/or detection of cysticercal antigens by monoclonal antibody-based enzyme-linked immunosorbent assay.
‡ Cysticercosis outside the central nervous system: Demonstration of cysticerci from biopsy of subcutaneous nodules, X-ray films or CT demonstrating cigar-shape calcifications in soft tissues, or parasite visualization in the anterior chamber of the eye.
† Suggestive clinical manifestations: Mainly seizures (often starting in individuals aged 20 to 49 years; the diagnosis of seizures in this context is not excluded if patients are outside of the typical age range); other manifestations include chronic headaches, focal neurologic deficits, intracranial hypertension, and cognitive decline.
** Cysticercosis-endemic area: A region where active transmission of cysticercosis has been documented.

Original table modified for this publication. From: Del Brutto OH, Nash TE, White AC Jr, et al. Revised diagnostic criteria for neurocysticercosis. J Neurol Sci 2017; 15:372. Table used with the permission of Elsevier Inc. All rights reserved.

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Diagnostic criteria for neurocysticercosis – Table B