Table 2.

Revised diagnostic criteria for neurocysticercosis

Categories of criteriaCriteria
* CT or MRI showing cystic lesions without scolex, enhancing lesions, or typical parenchymal brain calcifications.
† Enzyme-linked immunoelectrotransfer blot assay using purified extracts of Taenia solium antigens, as developed by the Centers for Disease Control and Prevention (Atlanta, GA).
‡ Solitary ring-enhancing lesions measuring less than 20 mm in diameter in patients presenting with seizures, a normal neurologic examination, and no evidence of an active systemic disease.
§ CT or MRI showing hydrocephalus or abnormal enhancement of the leptomeninges, and myelograms showing multiple filling defects in the column of contrast medium.
∥ Seizures, focal neurologic signs, intracranial hypertension, and dementia.
¶ Histologically confirmed subcutaneous or muscular cysticercosis, plain X-ray films showing “cigar-shaped” soft-tissue calcifications, or direct visualization of cysticerci in the anterior chamber of the eye.
ELISA = enzyme-linked immunosorbent assay.
Absolute1. Histologic demonstration of the parasite from biopsy of a brain or spinal cord lesion
2. Cystic lesions showing the scolex on CT or MRI
3. Direct visualization of subretinal parasites by funduscopic examination
Major1. Lesions highly suggestive of neurocysticercosis on neuroimaging studies*
2. Positive serum EITB for the detection of anticysticercal antibodies
3. Resolution of intracranial cystic lesions after therapy with albendazole or praziquantel
4. Spontaneous resolution of small single enhancing lesions
Minor1. Lesions compatible with neurocysticercosis on neuroimaging studies§
2. Clinical manifestations suggestive of neurocysticercosis
3. Positive CSF ELISA for detection of anticysticercal antibodies or cysticercal antigens
4. Cysticercosis outside the CNS
Epidemiologic1. Evidence of a household contact with Taenia solium infection
2. Individuals coming from or living in an area where cysticercosis is endemic
3. History of frequent travel to disease- endemic areas