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Validity of a PCR assay in CSF for the diagnosis of neurocysticercosis.

Validity of a PCR assay in CSF for the diagnosis of neurocysticercosis.
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Carpio A, Campoverde A, Romo ML, García L, Piedra LM, Pacurucu M, López N, Aguilar J, López S, Vintimilla LC, Toral AM, Peña-Tapia P,


Carpio A, Campoverde A, Romo ML, García L, Piedra LM, Pacurucu M, López N, Aguilar J, López S, Vintimilla LC, Toral AM, Peña-Tapia P, (click to view)

Carpio A, Campoverde A, Romo ML, García L, Piedra LM, Pacurucu M, López N, Aguilar J, López S, Vintimilla LC, Toral AM, Peña-Tapia P,

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Neurology(R) neuroimmunology & neuroinflammation 2017 01 164(2) e324 doi 10.1212/NXI.0000000000000324
Abstract
OBJECTIVE
To prospectively evaluate the validity of a PCR assay in CSF for the diagnosis of neurocysticercosis (NC).

METHODS
We conducted a multicenter, prospective case-control study, recruiting participants from 5 hospitals in Cuenca, Ecuador, from January 2015 to February 2016. Cases fulfilled validated diagnostic criteria for NC. For each case, a neurosurgical patient who did not fulfill the diagnostic criteria for NC was selected as a control. CT and MRI, as well as a CSF sample, were collected from both cases and controls. The diagnostic criteria to identify cases were used as a reference standard.

RESULTS
Overall, 36 case and 36 control participants were enrolled. PCR had a sensitivity of 72.2% (95% confidence interval [CI] 54.8%-85.8%) and a specificity of 100.0% (95% CI 90.3%-100.0%). For parenchymal NC, PCR had a sensitivity of 42.9% (95% CI 17.7%-71.1%), and for extraparenchymal NC, PCR had a sensitivity of 90.9% (95% CI 70.8%-98.9%).

CONCLUSIONS
This study demonstrated the usefulness of this PCR assay in CSF for the diagnosis of NC. PCR may be particularly helpful for diagnosing extraparenchymal NC when neuroimaging techniques have failed.

CLASSIFICATION OF EVIDENCE
This study provides Class III evidence that CSF PCR can accurately identify patients with extraparenchymal NC.

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