Neurocysticercosis criteria
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neurocysticercosis AND diagnosis
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Del Brutto 2017 revised diagnostic criteria neurocysticercosis absolute major minor epidemiologic
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https://pmc.ncbi.nlm.nih.gov/articles/PMC8364393
Revised Del Brutto 2017 diagnostic criteria for neurocysticercosis (NCC)
1. Absolute criteria
Any one establishes definitive NCC:
- Histologic demonstration of the parasite from a brain or spinal cord lesion
- Cystic lesion with a definite scolex on CT or MRI
- Direct visualization of a subretinal cysticercus on fundoscopy
2. Neuroimaging criteria
| Category | Criteria |
|---|---|
| Major | Cystic lesion without visible scolex; typical small enhancing lesion; multilobulated subarachnoid cystic lesion; typical parenchymal brain calcification |
| Confirmatory | Resolution of cystic lesion after cysticidal therapy; spontaneous resolution of a single small enhancing lesion; migration of a ventricular cyst on serial imaging |
| Minor | Obstructive hydrocephalus; abnormal enhancement of basal leptomeninges |
3. Clinical/exposure criteria
| Category | Criteria |
|---|---|
| Major | Specific anticysticercal antibody or cysticercal antigen detected by a well-standardized assay, for example EITB; cysticercosis outside the CNS; household contact with Taenia solium infection |
| Minor | Clinical syndrome suggestive of NCC, such as seizures or focal neurologic deficits; residence in, origin from, or frequent travel to a cysticercosis-endemic area |
Diagnostic certainty
Definitive NCC
Any one of the following:
- One absolute criterion, or
- Two major neuroimaging criteria + any clinical/exposure criterion, or
- One major neuroimaging + one confirmatory neuroimaging criterion + any clinical/exposure criterion, or
- One major neuroimaging criterion + two clinical/exposure criteria, of which at least one is major, and exclusion of alternative causes of similar imaging findings.
Probable NCC
Either:
- One major neuroimaging criterion + any two clinical/exposure criteria, or
- One minor neuroimaging criterion + one major clinical/exposure criterion.
A useful exam point: a positive serologic test alone does not diagnose NCC. The current criteria center diagnosis on compatible CNS neuroimaging, with direct parasite demonstration as definitive. The EITB is highly specific, but serology may be negative in a solitary lesion or calcified NCC.
Source: Bradley and Daroff’s Neurology in Clinical Practice, Table 79.6, p. 1707; Harrison’s Principles of Internal Medicine, 22nd ed., Table criteria, p. 1877. The framework is from the 2017 Del Brutto revision.
Neurofibromatosis
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Neurofibromatosis includes distinct genetic syndromes with different diagnostic criteria and surveillance. Key areas are:
- NF1 - clinical diagnostic criteria, café-au-lait macules, axillary freckling, neurofibromas, optic pathway glioma, Lisch nodules, and complications
- NF2-related schwannomatosis - bilateral vestibular schwannomas, meningiomas, ependymomas, and diagnostic criteria
- Other schwannomatoses - SMARCB1- and LZTR1-related disease
- Genetics and counseling - inheritance, testing, family screening
- Management and surveillance - neurologic, eye, skeletal, tumor, and blood-pressure follow-up
NF1 is the commonest type and is usually identified clinically; NF2-related schwannomatosis is primarily characterized by vestibular schwannomas and requires specialist imaging and genetic assessment.
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Revised Del Brutto 2017 diagnostic criteria for neurocysticercosis (NCC)
1. Absolute criteria
Any one establishes definitive NCC:
- Histologic demonstration of the parasite from a brain or spinal cord lesion
- Cystic lesion with a definite scolex on CT or MRI
- Direct visualization of a subretinal cysticercus on fundoscopy
2. Neuroimaging criteria
| Category | Criteria |
|---|---|
| Major | Cystic lesion without visible scolex; typical small enhancing lesion; multilobulated subarachnoid cystic lesion; typical parenchymal brain calcification |
| Confirmatory | Resolution of cystic lesion after cysticidal therapy; spontaneous resolution of a single small enhancing lesion; migration of a ventricular cyst on serial imaging |
| Minor | Obstructive hydrocephalus; abnormal enhancement of basal leptomeninges |
3. Clinical/exposure criteria
| Category | Criteria |
|---|---|
| Major | Specific anticysticercal antibody or cysticercal antigen detected by a well-standardized assay, for example EITB; cysticercosis outside the CNS; household contact with Taenia solium infection |
| Minor | Clinical syndrome suggestive of NCC, such as seizures or focal neurologic deficits; residence in, origin from, or frequent travel to a cysticercosis-endemic area |
Diagnostic certainty
Definitive NCC
Any one of the following:
- One absolute criterion, or
- Two major neuroimaging criteria + any clinical/exposure criterion, or
- One major neuroimaging + one confirmatory neuroimaging criterion + any clinical/exposure criterion, or
- One major neuroimaging criterion + two clinical/exposure criteria, of which at least one is major, and exclusion of alternative causes of similar imaging findings.
Probable NCC
Either:
- One major neuroimaging criterion + any two clinical/exposure criteria, or
- One minor neuroimaging criterion + one major clinical/exposure criterion.
A useful exam point: a positive serologic test alone does not diagnose NCC. The current criteria center diagnosis on compatible CNS neuroimaging, with direct parasite demonstration as definitive. The EITB is highly specific, but serology may be negative in a solitary lesion or calcified NCC.
Source: Bradley and Daroff’s Neurology in Clinical Practice, Table 79.6, p. 1707; Harrison’s Principles of Internal Medicine, 22nd ed., Table criteria, p. 1877. The framework is from the 2017 Del Brutto revision.Neurofibromatosis includes distinct genetic syndromes with different diagnostic criteria and surveillance. Key areas are:
- NF1 - clinical diagnostic criteria, café-au-lait macules, axillary freckling, neurofibromas, optic pathway glioma, Lisch nodules, and complications
- NF2-related schwannomatosis - bilateral vestibular schwannomas, meningiomas, ependymomas, and diagnostic criteria
- Other schwannomatoses - SMARCB1- and LZTR1-related disease
- Genetics and counseling - inheritance, testing, family screening
- Management and surveillance - neurologic, eye, skeletal, tumor, and blood-pressure follow-up
NF1 is the commonest type and is usually identified clinically; NF2-related schwannomatosis is primarily characterized by vestibular schwannomas and requires specialist imaging and genetic assessment.
Dose of faropenam pediatrics
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faropenem pediatric dose oral suspension prescribing information 5 mg/kg dose
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faropenem pediatric dosing
Faropenem pediatric dose: 5 mg/kg per dose orally, three times daily
Total: 15 mg/kg/day in 3 divided doses.
Total: 15 mg/kg/day in 3 divided doses.
Example: a 20 kg child:
5 × 20 = 100 mg per dose, three times daily.
5 × 20 = 100 mg per dose, three times daily.
Dose and duration must be selected by the treating pediatrician based on infection site, severity, culture results, age, renal function, and the specific formulation available. Faropenem availability and approved pediatric labeling vary by country, and it should not be used for viral respiratory infections. A review of pediatric use reports this 15 mg/kg/day regimen, divided TID, as the usual clinical dose: pediatric faropenem review.
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