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Ahmed S, Usmani S, Javed S, Hans A, Saboor S, Hanif A, Saleem SM, Shoib S. Neurocysticercosis presenting as psychosis: A case report and a brief literature review. SAGE Open Med Case Rep 2022; 10:2050313X221100396. [PMID: 35615741 PMCID: PMC9125614 DOI: 10.1177/2050313x221100396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 04/22/2022] [Indexed: 11/15/2022] Open
Abstract
Patients with neurocysticercosis, a common infection of the central nervous
system caused by Taenia solium, have been reported to develop
neuropsychiatric complications. We report a unique case of recurrent psychosis
caused by neurocysticercosis in a 37-year-old El Salvador immigrant woman and
discuss the underlying pathophysiological mechanisms of the complications. We
reviewed published case reports of neurocysticercosis that presented with
psychotic features and compared their diagnostic evaluation, the underlying
pathophysiology of complications and treatment regimen with our case. This
review concludes that neurocysticercosis should be considered in the
differential diagnosis of patients presenting with psychosis with a history of
residence in an endemic area.
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Affiliation(s)
- Saeed Ahmed
- Rutland Regional Medical Center, Rutland, VT, USA
| | - Sadia Usmani
- Psychiatry, Dow University of Health Sciences, Karachi, Pakistan
| | - Sana Javed
- Nishtar Medical University, Multan, Pakistan
| | - Aakash Hans
- Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | | | - Aunsa Hanif
- Sharif Medical and Dental College, Jati Umrah Lahore, Pakistan
| | | | - Sheikh Shoib
- Jawahar Lal Nehru Memorial Hospital, Srinagar, Jammu & Kashmir, India
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Bustos J, Gonzales I, Saavedra H, Handali S, Garcia HH. Neurocysticercosis. A frequent cause of seizures, epilepsy, and other neurological morbidity in most of the world. J Neurol Sci 2021; 427:117527. [PMID: 34147957 PMCID: PMC8800347 DOI: 10.1016/j.jns.2021.117527] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/14/2021] [Accepted: 05/31/2021] [Indexed: 12/07/2022]
Abstract
Neurocysticercosis is endemic in most of the world and in endemic areas it accounts for approximately 30% of cases of epilepsy. Appropriate diagnosis and management of neurocysticercosis requires understanding the diverse presentations of the disease since these will vary in regards to clinical manifestation, sensitivity of diagnostic tests, and most importantly, therapeutic approach. This review attempts to familiarize tropical neurology practitioners with the diverse types of neurocysticercosis and the more appropriate management approaches for each.
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Affiliation(s)
- J Bustos
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - I Gonzales
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - H Saavedra
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - S Handali
- Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - H H Garcia
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
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El-Kady AM, Allemailem KS, Almatroudi A, Abler B, Elsayed M. Psychiatric Disorders of Neurocysticercosis: Narrative Review. Neuropsychiatr Dis Treat 2021; 17:1599-1610. [PMID: 34079258 PMCID: PMC8164720 DOI: 10.2147/ndt.s306585] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/22/2021] [Indexed: 12/29/2022] Open
Abstract
Neurocysticercosis, the most common type of neuroparasitosis, is a condition in which the central nervous system (CNS) is infested with the pork tapeworm Taenia solium cysticercosis' larvae. Neurocysticercosis is the most widespread parasitic CNS disease worldwide, affecting more than 50 million individuals. As neurocysticercosis is prevalent in developing countries, the growing number of migrants and travelers increases prevalence in developed countries. Possible neuropsychiatric manifestations are depression, cognitive dysfunction, dementia, and visual hallucinations. Depending on the cysts' location in the CNS, focal neurology or psychiatric symptoms manifest. The diagnosis of neurocysticercosis is based on neuroimaging and serology. The correlation between specific symptoms and the cyst's location might help better understand psychiatric disorders' pathophysiology. Nonetheless, the exact prevalence of neurocysticercosis is seldom reported in patients with psychiatric disorders, which may be due to the lack of imaging availability in developing countries with a high prevalence.
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Affiliation(s)
- Asmaa M El-Kady
- Department of Medical Parasitology, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Khaled S Allemailem
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Ahmad Almatroudi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Birgit Abler
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, 89075, Germany
| | - Mohamed Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, 89075, Germany
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Abstract
Among the critically ill, infectious diseases can play a significant role in the etiology of neuropsychiatric disturbances. All critical care physicians are familiar with delirium as a secondary complication of systemic infection. This article focuses on key infectious diseases that commonly and directly produce neuropsychiatric symptoms, including direct infection of the central nervous system, human immunodeficiency virus infection, and AIDS.
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Affiliation(s)
- Sahil Munjal
- Department of Psychiatry, Westchester Medical Center, New York Medical College, 100 Woods Road, Valhalla, NY 10595, USA
| | - Stephen J Ferrando
- Department of Psychiatry, Westchester Medical Center, New York Medical College, 100 Woods Road, Valhalla, NY 10595, USA.
| | - Zachary Freyberg
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; Department of Cell Biology, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
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Gonzales I, Rivera JT, Garcia HH. Pathogenesis of Taenia solium taeniasis and cysticercosis. Parasite Immunol 2016; 38:136-46. [PMID: 26824681 DOI: 10.1111/pim.12307] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/25/2016] [Indexed: 12/22/2022]
Abstract
Taenia solium infections (taeniasis/cysticercosis) are a major scourge to most developing countries. Neurocysticercosis, the infection of the human nervous system by the cystic larvae of this parasite, has a protean array of clinical manifestations varying from entirely asymptomatic infections to aggressive, lethal courses. The diversity of clinical manifestations reflects a series of contributing factors which include the number, size and location of the invading parasites, and particularly the inflammatory response of the host. This manuscript reviews the different presentations of T. solium infections in the human host with a focus on the mechanisms or processes responsible for their clinical expression.
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Affiliation(s)
- I Gonzales
- Cysticercosis Unit, Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - J T Rivera
- Department of Microbiology and Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - H H Garcia
- Cysticercosis Unit, Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, Peru.,Department of Microbiology and Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
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Abstract
Human infections with foodborne pathogenic organisms are relatively well described in terms of their overt physical symptoms, such as diarrhea, abdominal cramps, vomiting, fever, and associated sequelae. Indeed, some of these are key for diagnosis and treatment, although it should be noted that, for some foodborne pathogens, the physical symptoms might be more diffuse, particularly those associated with some of the foodborne parasites. In contrast, the impact of these pathogens on mental health is less well described, and symptoms such as depression, anxiety, and general malaise are usually ignored when foodborne infections are recorded. Despite this, it is generally accepted that there are several psychiatric disorders of unknown etiology that may be associated with microbial pathogens. Depression, autism, hypochondriasis and anxiety, schizophrenia, and Tourette syndrome probably have multiple contributing causes, among which foodborne pathogens may play a decisive or contributory role, possibly sharing pathophysiological pathways with other environmental triggers. This review focuses on foodborne parasites and bacterial pathogens. Some foodborne parasites, such as metacestodes of Taenia solium and tissue cysts (bradyzoites) of Toxoplasma gondii , may affect mental health by directly infecting the brain. In contrast, bacterial infections and other parasitic infections may contribute to mental illness via the immune system and/or by influencing neurotransmission pathways. Thus, cytokines, for example, have been associated with depression and schizophrenia. However, infectious disease models for psychiatry require a more complete understanding of the relationship between psychiatric disorders and microbial triggers. This article reviews the current state of knowledge on the role of foodborne parasitic and bacterial pathogens in mental illness and identifies some of the gaps that should be addressed to improve diagnosis and treatment of mental health issues that are not solely related to psychiatric factors.
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Affiliation(s)
- Declan J Bolton
- Food Safety Department, Teagasc Food Research Centre, Ashtown, Dublin 15, Ireland
| | - Lucy J Robertson
- Department of Food Safety and Infection Biology, Norwegian University of Life Sciences (NMBU), 0454 Oslo, Norway
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Suicide risk and prevalence of major depressive disorder (MDD) among individuals infected with HIV-1 subtype C versus B in Southern Brazil. J Neurovirol 2016; 22:789-798. [PMID: 27431676 DOI: 10.1007/s13365-016-0454-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/15/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
Abstract
Major depressive disorder (MDD) is among the most prevalent neuropsychiatric disorders associated with HIV infection; however, its risks and neurobiologic correlates in diverse cultures are poorly understood. This study aimed to examine the frequency of MDD among HIV+ participants in southern Brazil. We hypothesized that the frequency and severity of MDD would be higher among individuals with HIV+ compared with HIV- and higher in HIV subtype B compared with C. Individuals with HIV (n = 39) as well as seronegative controls (n = 22) were enrolled in a cross-sectional, prospective, observational study. Current and lifetime history of MDD was diagnosed by MINI-Plus; symptom severity was assessed by Beck Depression Inventory-II (BDI-II). Current and past episodes of MDD were significantly more frequent in the HIV+ versus HIV- group: current MDD, 15 (38.5 %) vs. 0 (0 %), p = 0.0004; past MDD, 24 (61.5 %) vs. 3 (13.6 %), p = 0.0004. The median BDI-II score in the HIV+ group was significantly higher than that in the HIV- (13 (8-27.5) vs. 2.5 (1-5.5); p < 0.0001). Current suicide risk, defined as during the last month, was found in 18 % of participants in the HIV-positive and none in the HIV-negative group. Neither current MDD frequency (8 (57.1 %) vs. 6 (40 %), p = 0.47) nor BDI-II score differed across subtypes B and C. HIV+ group may be more likely to experience current MDD than HIV-. This was the first study to compare the frequency and severity of MDD in HIV subtypes B and C; we found no difference between HIV subtypes B and C.
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Gordon CA, McManus DP, Jones MK, Gray DJ, Gobert GN. The Increase of Exotic Zoonotic Helminth Infections: The Impact of Urbanization, Climate Change and Globalization. ADVANCES IN PARASITOLOGY 2016; 91:311-97. [PMID: 27015952 DOI: 10.1016/bs.apar.2015.12.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Zoonotic parasitic diseases are increasingly impacting human populations due to the effects of globalization, urbanization and climate change. Here we review the recent literature on the most important helminth zoonoses, including reports of incidence and prevalence. We discuss those helminth diseases which are increasing in endemic areas and consider their geographical spread into new regions within the framework of globalization, urbanization and climate change to determine the effect these variables are having on disease incidence, transmission and the associated challenges presented for public health initiatives, including control and elimination.
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Affiliation(s)
- Catherine A Gordon
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Malcolm K Jones
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; School of Veterinary Science, University of Queensland, Brisbane, QLD, Australia
| | - Darren J Gray
- Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Geoffrey N Gobert
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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Abate KH. Gender disparity in prevalence of depression among patient population: a systematic review. Ethiop J Health Sci 2015; 23:283-8. [PMID: 24307828 PMCID: PMC3847538 DOI: 10.4314/ejhs.v23i3.11] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Many people are unable to withstand the set point for usual vicissitudes of life and are overwhelmed by depression, especially when there is a potential stressor like a disease. Gender is very important in defining susceptibility and exposure to a number of mental health risks. The objective of this review is to systematically identify, appraise and synthesize the best available evidence on gender disparity in prevalence of depression among patient populations. METHODS Observational analytical studies done on patients of 18 years old were included. The JBI-MAStARI tool for extraction was used to pool quantitative data. Review Manager Software was used for meta-analysis and Odds ratios and their 95% confidence intervals were calculated. RESULT On Meta-analysis, a total of 19639 patients were involved, with male to female ratio of 1.14:1. The finding of the Meta analysis showed that male sex is 63% less likely to develop depression than female sex (Odds ratio=0.63, 95% Confidence Interval= 0.59, 0.68). The studies included were homogenous; Heterogeneity test: Chi(2) = 309.23, df = 30, (P < 0.00001). CONCLUSION Depression is more common among females than male patients.
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Shah R, Chakrabarti S. Neuropsychiatric manifestations and treatment of disseminated neurocysticercosis: a compilation of three cases. Asian J Psychiatr 2013; 6:344-6. [PMID: 23810145 DOI: 10.1016/j.ajp.2013.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 01/22/2013] [Accepted: 01/29/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Neurocysticercosis (NCC) is the most serious form of cysticercal infection and is a major public health problem in the developing world. NCC presents with a range of psychiatric symptoms besides neurological symptoms. There have been few reports from the Asian continent describing the neuropsychiatric manifestations. Our aim was to report manifestations and treatment issues in three cases with disseminated NCC. METHODS AND RESULTS Informed consent was obtained from all the three patients for the purpose of reporting. All three had multiple cysticerci in the brain and presented with several neuropsychiatric manifestations. All the patients had epilepsy and in addition they had varying psychiatric symptoms of delusions, hallucinations and catatonia, and cognitive symptoms. Also, interestingly in one patient, worsening of psychiatric and neurological symptoms correlated with anti-helminthic treatment. The psychotic symptoms responded to anti-psychotic treatment in one case. Anti-epileptics and steroid courses when given improved the clinical status. CONCLUSION NCC presents with a myriad of manifestations. Epilepsy, psychotic and cognitive symptoms respond to symptomatic treatment. Use of anti-parasitic agents might worsen the symptoms as has been reported in a few cases earlier.
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Affiliation(s)
- Ruchita Shah
- Department of Psychiatry, Post-Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Srivastava S, Chadda RK, Bala K, Majumdar P. A study of neuropsychiatric manifestations in patients of neurocysticercosis. Indian J Psychiatry 2013; 55:264-7. [PMID: 24082247 PMCID: PMC3777348 DOI: 10.4103/0019-5545.117146] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Neurocysticercosis (NCC) is an endemic parasitic infection of Asia, Africa, Latin America, and central Europe. Neuropsychiatric manifestations of the illness include epilepsy and behavioral disturbances. There is a dearth of systematic studies on psychiatric manifestations of NCC from various Asian counties. The present study assessed the prevalence of various psychiatric disorders in a cohort of patients with NCC attending a neurological service. MATERIALS AND METHODS Detailed psychiatric assessment was carried out on 50 patients of NCC with epilepsy and 50 patients of epilepsy without any evidence of NCC. Comprehensive Psychopathological Rating Scale was used to elicit the symptoms. Cognitive functions were assessed using Mini Mental Status Examination. Psychiatric diagnoses were made as per International Classification of Diseases, 10(th) edition (ICD-10). RESULTS Sixty eight percent of the patients with NCC suffered from a psychiatric disorder, as compared to 44% of those without NCC (P=0.02). Major depression and mixed anxiety depression were the two most common diagnoses. None of the patients was to found to suffer from a psychotic disorder. The most frequent site of brain lesion of NCC was the parietal lobe, followed by frontal lobes and disseminated lesions. Left sided lesions were associated with greater psychiatric morbidity. Focal seizures with or without secondary generalizations were present more frequently in patients with NCC whereas primary generalized seizures were more common in patients with idiopathic epilepsy (P=0.05). CONCLUSION Psychiatric manifestations are more common in patients of epilepsy with NCC than those without NCC. The treating clinician need to be vigilant about the phenomenon.
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Affiliation(s)
- Smita Srivastava
- Department of Psychiatry, Institute of Human Behaviour and Allied Sciences, Delhi, India
| | - Rakesh Kumar Chadda
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Kiran Bala
- Department of Neurology, Institute of Human Behaviour and Allied Sciences, Delhi, India
| | - Pradipta Majumdar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
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de Almeida SM, Gurjão SA. Quality of life assessment in patients with neurocysticercosis. J Community Health 2011; 36:624-30. [PMID: 21222023 DOI: 10.1007/s10900-010-9351-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objective of this study to investigate the impact of NCC upon the quality of life (QoL) compared to other chronic neurological diseases, epilepsy and headache. The study group consisted of 114 patients subdivided into four groups: NCC with epilepsy (n = 48), NCC without epilepsy (n = 17), epilepsy without NCC (n = 25) and chronic headache (n = 24). The QoL was evaluated by direct subjective quantification (scale of 0-10) and FACT-HN IV. NCC had impact on QoL, 53.8% patients dependent and needing help. The impact on QoL did not correlate with the classification of NCC, presence of cysts or calcifications and with CSF TP or number of WBCs. The presence of depression had a significant impact on the QoL of patients with NCC. Lack of seizure control tended to produce an adverse effect on the QoL in the group of NCC and epilepsy. NCC is not a benign disease; it has greater adverse effects on QoL of patients than epilepsy and headache, although without statistical significance. The presence of depression and uncontrolled seizures may have impact on QoL. Since asymptomatic patients were not evaluated, the results of this study are not applicable to all individuals with NCC.
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Affiliation(s)
- Sergio Monteiro de Almeida
- Virology Section, Clinical Pathology Laboratory, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil.
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Is the Presence of Depression Independent from Signs of Disease Activity in Patients with Neurocysticercosis? J Community Health 2011; 36:693-7. [DOI: 10.1007/s10900-011-9362-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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