Neurocysticercosis is the most common helminthic infection of the CNS but its diagnosis remains difficult. Clinical manifestations are nonspecific, most neuroimaging findings are not pathognomonic, and some serologic tests have low sensitivity and specificity. The authors provide diagnostic criteria for neurocysticercosis based on objective clinical, imaging, immunologic, and epidemiologic data. These include four categories of criteria stratified on the basis of their diagnostic strength, including the following: 1) absolute-histologic demonstration of the parasite from biopsy of a brain or spinal cord lesion, cystic lesions showing the scolex on CT or MRI, and direct visualization of subretinal parasites by funduscopic examination; 2) major-lesions highly suggestive of neurocysticercosis on neuroimaging studies, positive serum enzyme-linked immunoelectrotransfer blot for the detection of anticysticercal antibodies, resolution of intracranial cystic lesions after therapy with albendazole or praziquantel, and spontaneous resolution of small single enhancing lesions; 3) minor-lesions compatible with neurocysticercosis on neuroimaging studies, clinical manifestations suggestive of neurocysticercosis, positive CSF enzyme-linked immunosorbent assay for detection of anticysticercal antibodies or cysticercal antigens, and cysticercosis outside the CNS; and 4) epidemiologic-evidence of a household contact with Taenia solium infection, individuals coming from or living in an area where cysticercosis is endemic, and history of frequent travel to disease-endemic areas. Interpretation of these criteria permits two degrees of diagnostic certainty: 1) definitive diagnosis, in patients who have one

Taenia solium neurocysticercosis is a common cause of epileptic seizures and other neurological morbidity in most developing countries. It is also an increasingly common diagnosis in industrialized countries because of immigration from areas where it is endemic. Its clinical manifestations are highly variable and depend on the number, stage, and size of the lesions and the host's immune response. In part due to this variability, major discrepancies exist in the treatment of neurocysticercosis. A panel of experts in taeniasis/cysticercosis discussed the evidence on treatment of neurocysticercosis for each clinical presentation, and we present the panel's consensus and areas of disagreement. Overall, four general recommendations were made: (i) individualize therapeutic decisions, including whether to use antiparasitic drugs, based on the number, location, and viability of the parasites within the nervous system; (ii) actively manage growing cysticerci either with antiparasitic drugs or surgical excision; (iii) prioritize the management of intracranial hypertension secondary to neurocysticercosis before considering any other form of therapy; and (iv) manage seizures as done for seizures due to other causes of secondary seizures (remote symptomatic seizures) because they are due to an organic focus that has been present for a long time

BackgroundThere are various language adaptations of the Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL). In order to comply with the changes in DSM classification, the Spanish edition of the interview was in need of update and evaluation.MethodsK-SADS-PL was adapted to correspond to DSM-5 categories. All clinicians received training, and a 90% agreement was reached. Patients and their parents or guardians were interviewed and videotaped, and the videos were exchanged between raters. Factor analysis was performed and inter-rater reliability was calculated only in the case of diagnoses in which there were more than five patients.ResultsA total of 74 subjects were included. The Factor Analysis yielded six factors (Depressive, Stress Hyperarousal, Disruptive Behavioral, Irritable Explosive, Obsessive Repetitive and Encopresis), representing 72% of the variance. Kappa values for inter-rater agreement were larger than 0.7 for over half of the disorders.ConclusionsThe factor structure of diagnoses, made with the instrument was found to correspond to the DSM-5 disorder organization. The instrument showed good construct validity and inter-rater reliability, which makes it a useful tool for clinical research studies in children and adolescents.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1773-0) contains supplementary material, which is available to authorized users.

En la úitima década se han obtenido importantes avances en el tratamiento de las parasitosis intestinales (1. 2). La droga ideal, efectiva en dosis única contra todos o la mayoría de los parásitos del intestino, de bajo costo y sin toxicidad, todavía no se ha logrado. El enorme número de personas parasitadas, la mayoría de bajos recursos económicos y eluso de tratamientos en masa como medida de salud pública, hacen necesaria la obtención de nuevos medicamentos apropiados para este fin (3). Mencionaremos inicialmente las parasitósis y las drogas recomendadas y nos referiremos posteriormente a las drogas con más detalle. ventaja de la eficiencia en dosis única o en tratamiento de pocos días. BolantidiosisAunque tradicionalmente se han utilizado los antiamibianos se conocen estudios recientes que han demostrado la eficiencia del metronidazol y del nimorazol. AscoriosisLas dos drogas m8s efectivas son el pamoato de pirantel y el mebendazol. Son alternativas el levamisol y la piperazina. Amibiasis TricocefolosisSiempre que haya amibiasis intestinal sintombtica es necesario utilizar dos drogas: una que actúe contra los parásitos en los tejidos y otra que los destruya en la luz intestinal. No existe en la actualidad una droga única con ambas acciones totalmente efectivas. Los medicamentos de elección contra las amibas tisulares son los nitroimidazoles y los que las atacan en la luz son los derivados dicloroacetamídicos. Una droga alternativa en las formas tisulares es la dehidroemetina. En la amibiasis intestinal asintomática es suficiente el uso de las dicloacetamidas. GiordiasisEl mebendazol es la droga m8s utilizada. El pamoato de oxantel es similar en su acción. UncinariosisTanto el pamoato de pirantel como el mebendazol son recomendados como las drogas de elección. No es justificado en la actualidad usar otras drogas en Colombia. EstrongiloidiosisLa única droga efectiva es el tiabendazol. OxiuriosisEl pamoato de pirantel y el mebendazol Son tan efectivos los nitroimidazoles como constituyen el tratamiento de elección. Como la furazolidona. Los primeros tienen la alternativa existe la piperazina.

The efficacy of albendazole was evaluated in 20 Colombian patients with neurocysticercosis showing neurological symptoms. All had parenchymal non-enhancing cystic images by computerized tomography and a positive enzyme-linked immunosorbent assay for cysticercus antibodies in serum or cerebrospinal fluid. They stayed in hospital for 8 d during treatment with albendazole, 15 mg/kg/d in 2 divided doses, and were then followed for at least 6 months after treatment. The number of cysts was reduced by 50% after 6 months. In 7 (35%) all cysts disappeared, in 7 (35%) the number was reduced, and in the remaining 6 (30%) the number was unchanged. In the 13 patients who still had cysts at 6 months, 11 showed a moderate decrease in average cyst size and in 2 the size was unchanged. Side effects during treatment were observed in 60% of the cases, but only 3 required corticosteroids.