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)

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 NCC, including viable parenchymal NCC (VPN), single enhancing lesions (SEL), calcified parenchymal NCC (CPN), ventricular NCC (IVN), and subarachnoid NCC (SAN). Our recommendations are based on the best evidence available. Because of the complex variations in clinical manifestations and the limitations of the literature, many of the recommendations are based on observational studies, anecdotal data, or expert opinion rather than randomized clinical trials. The approaches we describe are intended to be both applicable and feasible in the United States and Canada (for simplicity, referred to here as North America). The recommendations may not apply for settings where resource constraints may limit their applicability. The executive summary in the following paragraphs lists the recommendations for the diagnosis and clinical management of NCC. A detailed description of the methods, background, and evidence summaries that support each of the recommendations can be found online in the full text of the guidelines. A criterion for grading evidence is presented in Figure 1.1 Note that diagnosis and management of patients with NCC can be challenging even with expert guidelines. Because of this complexity, clinicians with little experience with this disease should have a low threshold for consultation with an expert in the disease.