Bittencourt P R, Costa A J, Oliveira T V, Gracia C M, Gorz A M, Mazer S
Unidade de Neurologia Clínica, Hospital Nossa Senhora das Gracas, Curitiba PR, Brasil.
Arq Neuropsiquiatr. 1990 Sep;48(3):286-95. doi: 10.1590/s0004-282x1990000300004.
The wide clinical spectrum of neurocysticercosis has led to many attempts at clinical, radiological, CSF and other classifications. Based on an objective review of the relevant literature and on a prospective study of 42 patients with active neurocysticercosis, a new classification is proposed, based on clinical, tomographic, magnetic resonance and CSF evidence of viability of cysts. The first step is to define whether the disease is active or not. Inactive disease may be parenchymal calcifications or hydrocephalus. Active disease may be intraparenchymal, extraparenchymal or mixed. Statistical analysis of 42 cases with active disease shows intraparenchymal disease to occur in younger patients, perhaps more frequently in females, and to have a better prognosis than extraparenchymal of mixed disease. The latter appears to have the worst prognosis. Therapeutic implications are that only active disease warrants etiological therapy. There remain doubts about the best therapy for some infrequent subtypes of extraparenchymal and mixed disease.
神经囊尾蚴病广泛的临床谱导致了许多在临床、放射学、脑脊液及其他方面进行分类的尝试。基于对相关文献的客观回顾以及对42例活动性神经囊尾蚴病患者的前瞻性研究，提出了一种新的分类方法，该分类基于囊肿存活的临床、断层扫描、磁共振成像及脑脊液证据。第一步是确定疾病是否处于活动期。非活动性疾病可能是实质钙化或脑积水。活动性疾病可能是脑实质内、脑实质外或混合型。对42例活动性疾病病例的统计分析表明，脑实质内疾病多见于较年轻患者，女性可能更常见，且预后比脑实质外或混合型疾病更好。后两者似乎预后最差。治疗方面的意义在于只有活动性疾病才需要进行病因治疗。对于一些罕见的脑实质外和混合型疾病亚型的最佳治疗方法仍存在疑问。
