BACKGROUND: Cysticercosis due to Taenia solium is a cause of adult-acquired seizures and epilepsy even in patients with only calcified larval cysts. Transient perilesional brain oedema is seen around the calcified foci but its importance, association with seizures, incidence, and pathophysiology are unknown. METHODS: 110 patients with only calcified lesions and a history of seizures or severe headaches were followed prospectively in a cohort design to assess the incidence of seizure relapse. In a nested case-control substudy, perilesional oedema was assessed by MRI at the time of seizure in symptomatic patients and in matched asymptomatic controls taken from the study population. FINDINGS: Between November, 1999, and December, 2006, 29 patients had an incident seizure during a median follow up of 32.33 (SD 19.99) months, with an estimated 5-year seizure incidence of 36% (95% CI 25% to 49%). 24 of 29 (83%) patients with seizure relapse had an MRI evaluation within 5 days of the event; perilesional oedema was seen in 12 patients (50%) compared with two (9%) of 23 asymptomatic matched controls. INTERPRETATION: Perilesional oedema is common and associated with episodic seizure activity in patients with calcified neurocysticercosis. Our findings are probably representative of symptomatic patients in regions where T solium neurocysticercosis is endemic and suggest a unique and possibly preventable cause of seizures in this population.
BACKGROUND:Cysticercosis due to Taenia solium is a cause of adult-acquired seizures and epilepsy even in patients with only calcified larval cysts. Transient perilesional brain oedema is seen around the calcified foci but its importance, association with seizures, incidence, and pathophysiology are unknown. METHODS: 110 patients with only calcified lesions and a history of seizures or severe headaches were followed prospectively in a cohort design to assess the incidence of seizure relapse. In a nested case-control substudy, perilesional oedema was assessed by MRI at the time of seizure in symptomatic patients and in matched asymptomatic controls taken from the study population. FINDINGS: Between November, 1999, and December, 2006, 29 patients had an incident seizure during a median follow up of 32.33 (SD 19.99) months, with an estimated 5-year seizure incidence of 36% (95% CI 25% to 49%). 24 of 29 (83%) patients with seizure relapse had an MRI evaluation within 5 days of the event; perilesional oedema was seen in 12 patients (50%) compared with two (9%) of 23 asymptomatic matched controls. INTERPRETATION:Perilesional oedema is common and associated with episodic seizure activity in patients with calcified neurocysticercosis. Our findings are probably representative of symptomatic patients in regions where T solium neurocysticercosis is endemic and suggest a unique and possibly preventable cause of seizures in this population.
Authors: S M Montano; M V Villaran; L Ylquimiche; J J Figueroa; S Rodriguez; C T Bautista; A E Gonzalez; V C W Tsang; R H Gilman; H H Garcia Journal: Neurology Date: 2005-07-26 Impact factor: 9.910
Authors: Marco T Medina; Reyna M Durón; Lisandro Martínez; Juan Ramón Osorio; Ana L Estrada; Concepción Zúniga; Dora Cartagena; Julianne S Collins; Kenton R Holden Journal: Epilepsia Date: 2005-01 Impact factor: 5.864
Authors: M E Cruz; P M Schantz; I Cruz; P Espinosa; P M Preux; A Cruz; W Benitez; V C Tsang; J Fermoso; M Dumas Journal: Int J Epidemiol Date: 1999-08 Impact factor: 7.196
Authors: J Garcia-Noval; J C Allan; C Fletes; E Moreno; F DeMata; R Torres-Alvarez; H Soto de Alfaro; P Yurrita; H Higueros-Morales; F Mencos; P S Craig Journal: Am J Trop Med Hyg Date: 1996-09 Impact factor: 2.345
Authors: Luis Jean Pierre Meneses Quiroz; Isidro Gonzales; Edwin Javier Pretell; Herbert Saavedra; Hector H Garcia Journal: Neurol Clin Pract Date: 2015-12