Abstract

Diagnosis and Treatment of Neurocysticercosis: 2017 Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH).

Highlights

  • These guidelines present our approaches to the diagnosis and management of patients with the different forms of neurocysticercosis, including viable parenchymal neurocysticercosis, single enhancing lesions, calcified parenchymal neurocysticercosis, ventricular neurocysticercosis, and subarachnoid neurocysticercosis

  • While there is a wide range of clinical manifestations of neurocysticercosis, the 2 most common clinical presentations are with seizures and increased intracranial pressure

  • What is the role of antiparasitic drugs in viable intraparenchymal neurocysticercosis (VPN)?

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Summary

EXECUTIVE SUMMARY

Guidelines for the clinical management of patients with neurocysticercosis (NCC) were prepared by a panel of the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). The guidelines are intended for infectious disease specialists, neurologists, neurological surgeons, internists, pediatricians, and family practitioners. These guidelines present our approaches to the diagnosis and management of patients with the different forms of neurocysticercosis, including viable parenchymal neurocysticercosis, single enhancing lesions, calcified parenchymal neurocysticercosis, ventricular neurocysticercosis, and subarachnoid neurocysticercosis. Note that diagnosis and management of patients with neurocysticercosis can be challenging even with expert guidelines. Due to this complexity, clinicians with little experience with this disease should have a low threshold for consultation with an expert in the disease

How should NCC be diagnosed?
What imaging studies should be used to classify disease?
What additional tests should be performed prior to initiation of therapy?
How should antiparasitic and anti-inflammatory therapy be monitored?
What is the role of antiepileptic drugs in VPN?
What is the role of antiparasitic drugs in patients with SELs?
XIII. How should patients with SELs be followed?
XVII. How are extraparenchymal cysts best identified?
What is the optimal approach to adherent IVN?
XXIII. What is the role of neurosurgery in SAN?
XXVII. Should management be different in pregnant women?
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