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Verma A, Kumar A, Sachan D. Clinical characteristics and risk factors for seizures to recur in calcified neurocysticercosis : Prospective cohort Study. Acta Neurol Taiwan 2024; 33(4):153-160. [PMID: 38030224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
AIM Calcification of degenerating neurocysticercosis (NCC) is common and likely to occur late in the degenerative process and is important for seizure foci. The present study was aimed at identifying the clinical and radiological variables associated with seizure recurrence in people with single or multiple calcified NCC lesions. MATERIAL AND METHODS We evaluated 85 adult patients with calcified NCC lesions for recurrence of seizures during the follow-up period of one year. RESULTS The mean age of the study population was 24.49 ± 9.17 years. Nocturnal seizures were present in 43.5% and serial seizures in 42.4%. A single calcified lesion was present in 61 (71.8%), and perifocal oedema surrounding the calcified lesions was present in 38 (44.7%). Recurrence of seizures was noted in 37 (43.5%) of the cases. On multivariate analysis, the factors that were significantly associated with the recurrence of seizures were: nocturnal seizures [OR: 0.054 (0.015-0.199)], serial seizures [OR: 0.141 (0.041-0.485)], and perifocal oedema [OR: 0.031 (0.008-0.129)]. CONCLUSION In our study, serial seizures, nocturnal seizures, and perifocal oedema were linked with the recurrence of seizures in calcified NCC lesions. Perilesional oedema should be treated aggressively with anti-inflammatory/immunosuppressive therapy as well as with anti-seizure medication.
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Affiliation(s)
- Archana Verma
- Professor and Head Department of Neurology, All India Institute of Medical Sciences Raebareli Munshiganj, Dalmau Road, Raebareli, India
| | - Alok Kumar
- Professor and Head, Forensic Medicine and Toxicology, UP university of Medical Sciences, Saifai, Etawah, India
| | - Divyata Sachan
- Assistant professor, Department of community medicine SMMH Medical Sciences, Saharanpur, India
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Maldonado-Barrueco A, Utrilla C, Hernández-González A, Perteguer MJ, Díaz-Pollán B, Untoria-Tabares Y, Díaz-Menéndez M, Falces-Romero I, Gutiérrez-Arroyo A, García-Rodríguez J, Montero-Vega D. Intraventricular neurocysticercosis in a migrant from Honduras. J Travel Med 2024; 31:taad090. [PMID: 37406005 DOI: 10.1093/jtm/taad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 07/07/2023]
Abstract
We report in Madrid (Spain) a case of intraventricular neurocysticercosis in a migrant from Choluteca (Honduras), which was confirmed by epidemiological, radiological and microbiological criteria.
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Affiliation(s)
| | - Cristina Utrilla
- Radiology Department, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Ana Hernández-González
- Helminth Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid 28016, Spain
| | - María J Perteguer
- Helminth Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid 28016, Spain
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
| | - Beatriz Díaz-Pollán
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Yeray Untoria-Tabares
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Marta Díaz-Menéndez
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
- Imported Pathology and International Health Unit, CSUR for Adult and Pediatric Imported Tropical Pathology, High Level Isolation Unit, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Iker Falces-Romero
- Clinical Microbiology Department, Hospital Universitario La Paz, Madrid 28016, Spain
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
| | | | | | - Dolores Montero-Vega
- Clinical Microbiology Department, Hospital Universitario La Paz, Madrid 28016, Spain
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Ghosh R, León-Ruiz M, Dubey S, Benito-León J. Cerebral and spinal neurocysticercosis with extensive myocysticercosis presenting with new-onset convulsive status epilepticus and myopathic symptoms. Enferm Infecc Microbiol Clin (Engl Ed) 2024; 42:223-225. [PMID: 38216423 DOI: 10.1016/j.eimce.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/16/2023] [Indexed: 01/14/2024]
Affiliation(s)
- Ritwik Ghosh
- Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, West Bengal, India
| | - Moisés León-Ruiz
- Section of Clinical Neurophysiology, Department of Neurology, University Hospital "La Paz", Madrid, Spain
| | - Souvik Dubey
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Julián Benito-León
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Research Institute (i+12), University Hospital "12 de Octubre", Madrid, Spain; Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Department of Medicine, Complutense University, Madrid, Spain.
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Tellez-Arellano CA, Kuschick-Fehér J, Romero-Gonzalez FG, Fleury A. Neurocysticercosis: The duration of its preclinical phase relies on the parasite location. Trop Med Int Health 2024; 29:226-232. [PMID: 38200673 DOI: 10.1111/tmi.13964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVES Neurocysticercosis (NC) is a heterogeneous disease particularly in terms of response to treatment and prognosis. Parasite localization is one of the main factors involved in this heterogeneity. In this study we aim to determine whether differences in the duration of the preclinical phase associated with parasite location, could contribute to said heterogeneity. METHODS Ninety-nine patients were included, 24 with parasites in the parenchyma (PAR), 56 in the subarachnoid (SA) space and 19 in the ventricular system (IV). A questionnaire designed to assess exposure to classic NC risk factors 5, 10, 15, 20 and more than 20 years prior to diagnosis was applied. The results were compared between the three groups. Also, asymptomatic relatives of patients who had shared their living conditions in childhood or more recently were included and underwent brain scan and blood testing for specific antibodies. RESULTS Over the course of their lives, exposure to risk factors decreased significantly for all patients, although the decrease was more evident in patients with parasites in the SA space (p < 0.001) compared to patients with PAR (p = 0.011) or IV cysts (p = 0.020). Five years prior to diagnosis, exposure to risk factors was significantly higher in patients with PAR or IV NC than in patients with SA NC (p = 0.04). Furthermore, individuals in close contact with PAR or IV patients in the years preceding diagnosis were more likely to have asymptomatic NC, specific antibodies in sera, particularly IgM, compared to individuals in close contact with SA patients during the same period. CONCLUSIONS All these findings are highly suggestive of the possibility of a more recent infection of patients affected by parenchymal and ventricular NC than of patients with subarachnoid NC. Consequently, subarachnoid disease could be considered a chronic disease, which, probably contributes to the severity of the disease as well as the minimal response to medical treatment.
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Affiliation(s)
| | - Jan Kuschick-Fehér
- Clínica de neurocisticercosis, Instituto Nacional de Neurologia y Neurocirugía Manuel Velasco Suarez, Ciudad de México, Mexico
- Departamento de Neurología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - Franco Gabriel Romero-Gonzalez
- Clínica de neurocisticercosis, Instituto Nacional de Neurologia y Neurocirugía Manuel Velasco Suarez, Ciudad de México, Mexico
- University of Bern, ISPM, Bern, Switzerland
| | - Agnès Fleury
- Clínica de neurocisticercosis, Instituto Nacional de Neurologia y Neurocirugía Manuel Velasco Suarez, Ciudad de México, Mexico
- Unidad de Neuro Inflamación, Departamento de Medicina Genómica y Toxicología ambiental, Instituto de Investigación Biomédicas, UNAM/Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez (INNN-MVS), México City, Mexico
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Eggink H, Maas M, van den Brand JM, Dekker J, Franssen F, Hoving EW, Kortbeek LM, Kranendonk ME, Meiners LC, Rittscher AE, Roelfsema J, Schölvinck EH. Taenia martis Neurocysticercosis-Like Lesion in Child, Associated with Local Source, the Netherlands. Emerg Infect Dis 2024; 30:555-559. [PMID: 38407150 PMCID: PMC10902551 DOI: 10.3201/eid3003.231402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
A neurocysticercosis-like lesion in an 11-year-old boy in the Netherlands was determined to be caused by the zoonotic Taenia martis tapeworm. Subsequent testing revealed that 15% of wild martens tested in that region were infected with T. martis tapeworms with 100% genetic similarity; thus, the infection source was most likely local.
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Affiliation(s)
| | | | - Judith M.A. van den Brand
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Jasja Dekker
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Frits Franssen
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Eelco W. Hoving
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Laetitia M. Kortbeek
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Mariëtte E.G. Kranendonk
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Linda C. Meiners
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Anne E. Rittscher
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Jeroen Roelfsema
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Elisabeth H. Schölvinck
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
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Chakrabarty B, Gulati S, Kumar A, Jauhari P, Saini S, Pandey T, Pandey RM, Panda P, Anand V, Singh S, Kamila G. Incident Breakthrough Seizures, Serum Matrix Metalloproteinase-9 and Perfusion Magnetic Resonance Imaging Parameters in a Cohort of Children and Adolescents With Neurocysticercosis: A Longitudinal Observational Study. Pediatr Neurol 2024; 151:45-52. [PMID: 38101307 DOI: 10.1016/j.pediatrneurol.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/21/2023] [Accepted: 11/19/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND The current study estimated incident breakthrough seizures, serum matrix metalloproteinase-9 (MMP-9), and perfusion magnetic resonance imaging (MRI) parameters in five- to 18-year-olds with neurocysticercosis (NCC) from colloidal or vesicular through calcified stages over at least 24 months' follow-up. METHODS Single, colloidal, or vesicular parenchymal NCC cases were treated with albendazole and steroids and followed at a tertiary care north Indian hospital. Serum MMP-9 was estimated in colloidal or vesicular treatment-naive state and in a subset of calcified cases at six-month follow-up. The same subset of calcified cases also underwent perfusion MRI of the brain at six-month follow-up. RESULTS Among 70 cases, 70% calcified at six-month follow-up. Over a median follow-up of 30 months, the incidence of breakthrough seizures was 48.6% (61.2% in calcified and 19.2% in resolved, P = 0.001; 32.9% early [within six months] and 15.7% late [beyond six months], P = 0.02). Serum MMP-9 levels were higher in colloidal and vesicular compared with calcified stage (242.5 vs 159.8 ng/mL, P = 0.007); however, there was no significant association with breakthrough seizures and/or calcification in follow-up. In a subgroup of calcified cases (n = 31), the median relative cerebral blood volume on perfusion MRI in and around the lesion was lower in those with seizures (n = 12) than in those without (n = 19) (10.7 vs 25.2 mL/100 g, P = 0.05). CONCLUSIONS In post-treatment colloidal or vesicular NCC, incident breakthrough seizures decrease beyond six months. In calcified NCC with remote breakthrough seizures, significant perilesional hypoperfusion is seen compared with those without seizures.
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Affiliation(s)
- Biswaroop Chakrabarty
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, New Delhi, India.
| | - Sheffali Gulati
- Child Neurology Division, Department of Pediatrics, Centre of Excellence and Advanced Research on Childhood Neurodevelopmental Disorders, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Atin Kumar
- Department of Radiodiagnosis, JPNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Prashant Jauhari
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Savita Saini
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Tapish Pandey
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Prateek Panda
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Vaishakh Anand
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Sonali Singh
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Gautam Kamila
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, New Delhi, India
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Xiao G, Shu M. Massive neurocysticercosis in a ten-year-old girl: a case report. BMC Pediatr 2024; 24:79. [PMID: 38267910 PMCID: PMC10807077 DOI: 10.1186/s12887-024-04530-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Massive neurocysticercosis is a rare form of neurocysticercosis, and can lead to serious conditions and even death. CASE PRESENTATION Here we present a case of ten-year-old Tibetan girl who developed headache and vomiting. Her brain magnetic resonance imaging (MRI) illustrated lots of intracranial cystic lesions, and no obvious extracranial lesions were found. Serum immunoglobulin G antibodies against cysticerci were positive by the use of an enzyme-linked immunosorbent assay (ELISA). These results in combination with her medical history were in line with massive neurocysticercosis. The patients recovered well after supportive management and antiparasitic treatment. CONCLUSIONS This case provides insights on the diagnosis and treatment of massive neurocysticercosis. The treatment of patients with massive neurocysticercosis should be in an individualized fashion, and the use of antiparasitic drugs in these patients must be decided after carefully weighing the risks and benefits.
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Affiliation(s)
- Guoguang Xiao
- Department of Pediatrics, West China Second Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610041, Sichuan Province, P. R. China
- West China Xiamen Hospital of Sichuan University, Xiamen, 361022, China
| | - Min Shu
- Department of Pediatrics, West China Second Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610041, Sichuan Province, P. R. China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, China.
- West China Xiamen Hospital of Sichuan University, Xiamen, 361022, China.
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8
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Lu VM, Saad AG, Shah AH. Histologic Anatomy of Neurocysticercosis. JAMA Neurol 2023; 80:1371-1372. [PMID: 37870830 DOI: 10.1001/jamaneurol.2023.3739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
This case report describes a 23-year-old male patient with tonic-clonic seizure and subsequent treatment with anthelmintic therapy.
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Affiliation(s)
- Victor M Lu
- Department of Neurologic Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Ali G Saad
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida
| | - Ashish H Shah
- Department of Neurologic Surgery, University of Miami Miller School of Medicine, Miami, Florida
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9
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Steinsiepe VK, Ruf MT, Rossi M, Fricker-Feer C, Kolenc D, Buser BS, Concu M, Neumayr A, Schneider UC. Human Taenia martis Neurocysticercosis, Switzerland. Emerg Infect Dis 2023; 29:2569-2572. [PMID: 37987597 PMCID: PMC10683805 DOI: 10.3201/eid2912.230697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
Neurocysticercosis is almost exclusively caused by Taenia solium tapeworms. We describe a case of neurocysticercosis in Switzerland caused by infection with Taenia martis, the marten tapeworm, and review all 5 published cases of human infection with the marten tapeworm. In epidemiologically nonplausible cases of neurocysticercosis, zoonotic spillover infections should be suspected.
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10
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Machado S, Ewaldo Lindorfer Neto E, de Carvalho Dornelas B, de Martino Luppi A, Henrique de Oliveira E, Cesar Marinho Dias P, Dos Reis MQ, Dos Santos DF. Intramedullary Neurocysticercosis: A Case Report. Neurology 2023; 101:1023-1024. [PMID: 37813586 PMCID: PMC10727212 DOI: 10.1212/wnl.0000000000207911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/18/2023] [Indexed: 10/14/2023] Open
Affiliation(s)
- Stefano Machado
- From the HC-UFU (Neurology) (S.M.), HC-UFU (Neurosurgery) (E.E.L.N.), Pathology Departament (UFU/EBSERH) (B.C.D.), Radiology Division (A.M.L., E.H.O.), Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Neurosurgeon at Hospital de Clínicas de Uberlandia (UFU/EBSERH) (P.C.M.D.); Hospital de Clínicas de Uberlandia (UFU) (M.Q.R.); and Clinics' Hospital (D.F.S.), School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG.
| | - Egon Ewaldo Lindorfer Neto
- From the HC-UFU (Neurology) (S.M.), HC-UFU (Neurosurgery) (E.E.L.N.), Pathology Departament (UFU/EBSERH) (B.C.D.), Radiology Division (A.M.L., E.H.O.), Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Neurosurgeon at Hospital de Clínicas de Uberlandia (UFU/EBSERH) (P.C.M.D.); Hospital de Clínicas de Uberlandia (UFU) (M.Q.R.); and Clinics' Hospital (D.F.S.), School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG
| | - Bruno de Carvalho Dornelas
- From the HC-UFU (Neurology) (S.M.), HC-UFU (Neurosurgery) (E.E.L.N.), Pathology Departament (UFU/EBSERH) (B.C.D.), Radiology Division (A.M.L., E.H.O.), Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Neurosurgeon at Hospital de Clínicas de Uberlandia (UFU/EBSERH) (P.C.M.D.); Hospital de Clínicas de Uberlandia (UFU) (M.Q.R.); and Clinics' Hospital (D.F.S.), School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG
| | - Andrea de Martino Luppi
- From the HC-UFU (Neurology) (S.M.), HC-UFU (Neurosurgery) (E.E.L.N.), Pathology Departament (UFU/EBSERH) (B.C.D.), Radiology Division (A.M.L., E.H.O.), Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Neurosurgeon at Hospital de Clínicas de Uberlandia (UFU/EBSERH) (P.C.M.D.); Hospital de Clínicas de Uberlandia (UFU) (M.Q.R.); and Clinics' Hospital (D.F.S.), School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG
| | - Elder Henrique de Oliveira
- From the HC-UFU (Neurology) (S.M.), HC-UFU (Neurosurgery) (E.E.L.N.), Pathology Departament (UFU/EBSERH) (B.C.D.), Radiology Division (A.M.L., E.H.O.), Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Neurosurgeon at Hospital de Clínicas de Uberlandia (UFU/EBSERH) (P.C.M.D.); Hospital de Clínicas de Uberlandia (UFU) (M.Q.R.); and Clinics' Hospital (D.F.S.), School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG
| | - Paulo Cesar Marinho Dias
- From the HC-UFU (Neurology) (S.M.), HC-UFU (Neurosurgery) (E.E.L.N.), Pathology Departament (UFU/EBSERH) (B.C.D.), Radiology Division (A.M.L., E.H.O.), Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Neurosurgeon at Hospital de Clínicas de Uberlandia (UFU/EBSERH) (P.C.M.D.); Hospital de Clínicas de Uberlandia (UFU) (M.Q.R.); and Clinics' Hospital (D.F.S.), School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG
| | - Maykell Queiroz Dos Reis
- From the HC-UFU (Neurology) (S.M.), HC-UFU (Neurosurgery) (E.E.L.N.), Pathology Departament (UFU/EBSERH) (B.C.D.), Radiology Division (A.M.L., E.H.O.), Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Neurosurgeon at Hospital de Clínicas de Uberlandia (UFU/EBSERH) (P.C.M.D.); Hospital de Clínicas de Uberlandia (UFU) (M.Q.R.); and Clinics' Hospital (D.F.S.), School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG
| | - Diogo Fernandes Dos Santos
- From the HC-UFU (Neurology) (S.M.), HC-UFU (Neurosurgery) (E.E.L.N.), Pathology Departament (UFU/EBSERH) (B.C.D.), Radiology Division (A.M.L., E.H.O.), Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Neurosurgeon at Hospital de Clínicas de Uberlandia (UFU/EBSERH) (P.C.M.D.); Hospital de Clínicas de Uberlandia (UFU) (M.Q.R.); and Clinics' Hospital (D.F.S.), School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG
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11
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Panda PK, Elwadhi A, Gupta D, Tomar A, Sherwani P, Sharawat IK. Development and validation of a predictive model assessing the risk of seizure recurrence in children with neurocysticercosis. Epilepsy Res 2023; 197:107239. [PMID: 37862917 DOI: 10.1016/j.eplepsyres.2023.107239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/03/2023] [Accepted: 10/08/2023] [Indexed: 10/22/2023]
Abstract
INTRODUCTION Neurocysticercosis (NCC) is a significant factor contributing to the incidence of seizures in developing countries. While numerous studies have investigated the recurrence of seizures in NCC, their reliability is often limited. METHODS We assessed the socio-demographic, clinical, and neuroimaging details of 161 children with seizures caused by NCC. We monitored them for seizure recurrence over a 6-month follow-up period. We divided the children into two groups: those with seizure recurrence and those without. Subsequently, we identified predictive factors associated with seizure recurrence through univariate analysis, followed by multivariate binary logistic regression. We evaluated the prognostic model for discrimination and calibration and then internally validated it using the bootstrap method. RESULTS A total of 23 children experienced breakthrough seizures. In multivariate analysis, the presence of epileptiform abnormalities in electroencephalogram (EEG), more than 5 NCC lesions, the presence of perilesional edema greater than 2 cm in maximum dimension, and a cluster of seizures before presentation were significantly associated with seizure recurrence (p < 0.05). These factors were included in the final NEPC (Number of NCC lesions, Epileptiform EEG abnormality, Perilesional edema, and Cluster of seizures) score. The final model exhibited good discrimination (AUC = 89.1 %; 95 % CI=80.5-95.3 %, p < 0.001) and calibration (p = 0.54). A score of 4 appeared to be the optimal threshold for discriminating between individuals with and without seizure recurrence, with sensitivity and specificity values of 85 % and 87 %, respectively. Interrater reliability was very strong between two pediatric neurologists and strong between a pediatric neurologist and a pediatric neurology trainee resident (k = 0.92 and 0.86, respectively). CONCLUSION The NEPC score demonstrates good sensitivity and specificity in predicting seizure recurrence in pediatric children with NCC.
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Affiliation(s)
- Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Aman Elwadhi
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Diksha Gupta
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Apurva Tomar
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Poonam Sherwani
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India.
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12
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Portela L, Cardoso TM, Reis F. Muscular and brain cysticercosis. Rev Soc Bras Med Trop 2023; 56:e04392023. [PMID: 37878829 PMCID: PMC10588824 DOI: 10.1590/0037-8682-0439-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/22/2023] [Indexed: 10/27/2023] Open
Affiliation(s)
- Luã Portela
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Anestesiologia, Oncologia e Radiologia, Campinas, SP, Brasil.Universidade Estadual de CampinasFaculdade de Ciências MédicasDepartamento de Anestesiologia, Oncologia e RadiologiaCampinasSPBrasil
| | - Tânia Marchiori Cardoso
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Neurologia, Campinas, SP, Brasil.Universidade Estadual de CampinasFaculdade de Ciências MédicasDepartamento de NeurologiaCampinasSPBrasil
| | - Fabiano Reis
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Anestesiologia, Oncologia e Radiologia, Campinas, SP, Brasil.Universidade Estadual de CampinasFaculdade de Ciências MédicasDepartamento de Anestesiologia, Oncologia e RadiologiaCampinasSPBrasil
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13
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Wahlster S, Zunt J, Bonow R. Surgical Debulking Before Medical Management in a Patient With Massive Racemose Neurocysticercosis. Neurology 2023; 101:627-628. [PMID: 37414569 PMCID: PMC10573143 DOI: 10.1212/wnl.0000000000207465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/13/2023] [Indexed: 07/08/2023] Open
Affiliation(s)
- Sarah Wahlster
- From the Department of Neurology (S.W., J.Z.), Department of Neurological Surgery (S.W., R.B.), Department of Global Health (J.Z.), and Harborview Injury Prevention Research Center (R.B.), University of Washington, Seattle.
| | - Joseph Zunt
- From the Department of Neurology (S.W., J.Z.), Department of Neurological Surgery (S.W., R.B.), Department of Global Health (J.Z.), and Harborview Injury Prevention Research Center (R.B.), University of Washington, Seattle
| | - Robert Bonow
- From the Department of Neurology (S.W., J.Z.), Department of Neurological Surgery (S.W., R.B.), Department of Global Health (J.Z.), and Harborview Injury Prevention Research Center (R.B.), University of Washington, Seattle
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14
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Hudelist B, Tauziede-Espariat A, Senova S. Isolated Intraventricular Neurocysticercosis: Atypical Presentation of a Colloid Cyst. World Neurosurg 2023; 178:134-135. [PMID: 37495101 DOI: 10.1016/j.wneu.2023.07.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023]
Abstract
Neurocysticercosis is a condition characterized by the presence of Taenia solium (larval stage: Cysticercus cellulosae) in the brain and is classified as a tropical disease. Although it was previously uncommon in Europe, the number of cases has been increasing over the past decade. In this report, we present a case of a patient who was admitted with symptoms of raised intracranial pressure and biventricular hydrocephalus, without evidence of infection. Imaging studies revealed the presence of an atypical colloid cyst, which was subsequently removed using a neurosurgical endoscopic approach. Anatomopathologic analysis confirmed the presence of a C. cellulosae larva. It is crucial not to overlook or misdiagnose isolated intraventricular neurocysticercosis because it can lead to complications such as delayed diagnosis and dissemination of the cyst.
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Affiliation(s)
- Benoit Hudelist
- Neurosurgery Department, Université Paris Est Créteil, Henri Mondor Hospital, Créteil, France.
| | - Arnault Tauziede-Espariat
- Department of Neuropathology, GHU Paris-Psychiatry and Neuroscience, Saint-Anne Hospital, Paris, France; Institute of Psychiatry and Neurosciences of Paris, IMA-BRAIN, Paris, France
| | - Suhan Senova
- Neurosurgery Department, Université Paris Est Créteil, Henri Mondor Hospital, Créteil, France
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15
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Qian Z, Li Z, Zhang Z, Chen J, Chen X, Gao J. Teaching NeuroImage: Antibody-Negative Giant Subarachnoid Neurocysticercosis With Isolated Motor Impairment. Neurology 2023; 101:e1278-e1279. [PMID: 37407256 PMCID: PMC10516279 DOI: 10.1212/wnl.0000000000207529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/03/2023] [Indexed: 07/07/2023] Open
Affiliation(s)
- Zhihong Qian
- From the Department of Basic Medical Sciences (Z.Q.), School of Medicine, Tsinghua University; Departments of Neurosurgery (Z.L., J.G.), Pathology (Z.Z., J.C.), and Orthopedics (X.C.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhimin Li
- From the Department of Basic Medical Sciences (Z.Q.), School of Medicine, Tsinghua University; Departments of Neurosurgery (Z.L., J.G.), Pathology (Z.Z., J.C.), and Orthopedics (X.C.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhiwen Zhang
- From the Department of Basic Medical Sciences (Z.Q.), School of Medicine, Tsinghua University; Departments of Neurosurgery (Z.L., J.G.), Pathology (Z.Z., J.C.), and Orthopedics (X.C.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingci Chen
- From the Department of Basic Medical Sciences (Z.Q.), School of Medicine, Tsinghua University; Departments of Neurosurgery (Z.L., J.G.), Pathology (Z.Z., J.C.), and Orthopedics (X.C.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Chen
- From the Department of Basic Medical Sciences (Z.Q.), School of Medicine, Tsinghua University; Departments of Neurosurgery (Z.L., J.G.), Pathology (Z.Z., J.C.), and Orthopedics (X.C.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Gao
- From the Department of Basic Medical Sciences (Z.Q.), School of Medicine, Tsinghua University; Departments of Neurosurgery (Z.L., J.G.), Pathology (Z.Z., J.C.), and Orthopedics (X.C.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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16
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Moreira CAA, Murayama LHV, Martins TDC, Oliveira VT, Generoso D, Machado VMDV, Batah SS, Fabro AT, Bazan R, Zanini MA, Sciutto E, Fleury A, Hamamoto Filho PT. Sexual dimorphism in the murine model of extraparenchymal neurocysticercosis. Parasitol Res 2023; 122:2147-2154. [PMID: 37428312 DOI: 10.1007/s00436-023-07913-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023]
Abstract
Neurocysticercosis is a heterogeneous disease, and the patient's sex seems to play a role in this heterogeneity. Hosts' sexual dimorphism in cysticercosis has been largely explored in the murine model of intraperitoneal Taenia crassiceps cysticercosis. In this study, we investigated the sexual dimorphism of inflammatory responses in a rat model of extraparenchymal neurocysticercosis caused by T. crassiceps. T. crassiceps cysticerci were inoculated in the subarachnoid space of Wistar rats (25 females, 22 males). Ninety days later, the rats were euthanized for histologic, immunohistochemistry, and cytokines studies. Ten animals also underwent a 7-T magnetic resonance imaging (MRI). Female rats presented a higher concentration of immune cells in the arachnoid-brain interface, reactive astrogliosis in the periventricular region, in situ pro-inflammatory cytokine (interleukin [IL]-6) and anti-inflammatory cytokine (IL-10), and more intense hydrocephalus on MRI than males. Intracranial hypertension signals were not observed during the observational period. Overall, these results suggest sexual dimorphism in the intracranial inflammatory response that accompanied T. crassiceps extraparenchymal neurocysticercosis.
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Affiliation(s)
- Carlos Alexandre Aguiar Moreira
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Luis Henrique Vallesquino Murayama
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Tatiane de Camargo Martins
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Vinicius Tadeu Oliveira
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Diego Generoso
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | | | | | | | - Rodrigo Bazan
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Marco Antônio Zanini
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Edda Sciutto
- Institute of Biomedical Investigations, UNAM - National Autonomous University of Mexico, Mexico City, Mexico
| | - Agnès Fleury
- Institute of Biomedical Investigations, UNAM - National Autonomous University of Mexico, Mexico City, Mexico
- Instituto Nacional de Neurología y Neurocirurgía, Mexico City, Mexico
| | - Pedro Tadao Hamamoto Filho
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil.
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17
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Vargas-Urbina J, Martinez-Silva R, Anicama-Lima W. [Neurocysticercosis: A rare cause of a single brain granuloma]. Med Clin (Barc) 2023; 161:177-178. [PMID: 37296044 DOI: 10.1016/j.medcli.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/01/2023] [Accepted: 04/09/2023] [Indexed: 06/12/2023]
Affiliation(s)
- John Vargas-Urbina
- Servicio de Neurocirugía Vascular, Tumores y Funcional, Departamento de Neurocirugía, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.
| | - Raúl Martinez-Silva
- Servicio de Neurocirugía Vascular, Tumores y Funcional, Departamento de Neurocirugía, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
| | - William Anicama-Lima
- Servicio de Anatomía Patológica, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
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18
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Merrill L, Hurd A, Hohn L, Reynen P. A Case of Neurocysticercosis in Rural South Dakota. S D Med 2023; 76:353-356. [PMID: 37734078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Neurocysticercosis (NCC) is a rare, potentially life-threatening parasitic infection endemic in many developing countries where pig farming and pork consumption are popular. The rates of neurocysticercosis could increase in the U.S. due to the influx of immigration from Central and South America, sub-Saharan Africa, and parts of Asia. Careful evaluation, diagnosis, and treatment is needed to prevent complications from the disease. We present a case of neurocysticercosis which presented as an unresponsive adult female in a rural South Dakota healthcare facility.
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Affiliation(s)
- Luke Merrill
- University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota
| | - Autumn Hurd
- University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota
| | - Layne Hohn
- University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota
| | - Peter Reynen
- Avera Milbank Area Hospital, Milbank, South Dakota
- Department of Family Medicine, University of South Dakota Sanford School of Medicine
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19
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Mansour MA, Tahir M. Intraventricular neurocysticercosis: A correlative radiopathological image. Neurol Sci 2023; 44:2991-2992. [PMID: 37178212 DOI: 10.1007/s10072-023-06810-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 05/15/2023]
Affiliation(s)
- Moustafa A Mansour
- Department of Neurology and Neurologic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
- Department of Neurology and Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
- Division of Neuro-Intensive Care, Dar Al-Fouad Medical Corporation, Cairo, Egypt.
- Department of Emergency Medicine and Critical Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
| | - Mohamed Tahir
- Department of Emergency Medicine and Critical Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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20
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Nateros F, Saenz E, Saavedra H, Gonzales I, Pretell EJ, Perez E, Castillo Y, Bustos JA, Garcia HH. Older Age in Subarachnoid Neurocysticercosis Reflects a Long Prepatent Period. Am J Trop Med Hyg 2023; 108:1188-1191. [PMID: 37127275 PMCID: PMC10540123 DOI: 10.4269/ajtmh.22-0791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/07/2023] [Indexed: 05/03/2023] Open
Abstract
Patients with subarachnoid neurocysticercosis (NCC) are usually older than those with parenchymal disease. Whether this difference reflects a prolonged presymptomatic period or a delay in diagnosis is not clear. From 408 eligible patients, we retrospectively compared the age at symptom onset in 140 patients diagnosed with parenchymal (pure viable or pure calcified) and subarachnoid NCC who had a confirmatory image available not more than 2 years after the beginning of symptoms. Patients with mixed (parenchymal and subarachnoid) NCC or those with parenchymal cysts at different stages (viable and/or degenerating and/or calcified) were not included. After controlling by sex and residence in rural endemic regions, the mean age at symptom onset in patients with subarachnoid disease was 13.69 years older than those with viable parenchymal disease. A long incubation period is a major contributing factor to older age at presentation in subarachnoid NCC, independent of delayed diagnosis or access to care.
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Affiliation(s)
- Fernando Nateros
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Edith Saenz
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Herbert Saavedra
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Isidro Gonzales
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Unidad de Investigación, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | | | - Erika Perez
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Yesenia Castillo
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Javier A. Bustos
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hector H. Garcia
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - for the Cysticercosis Working Group in Peru
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Unidad de Investigación, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Hospital Nacional Alberto Sabogal, Callao, Peru
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru
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21
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Anaya-González JL, López-Muñoz F, Builla ECÁ, Miniet-Castillo AE. [Neurocysticercosis, its clinical and tomographic correlation. Reply]. Rev Neurol 2023; 76:313-314. [PMID: 37102257 PMCID: PMC10478146 DOI: 10.33588/rn.7609.2023116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Indexed: 04/28/2023]
Affiliation(s)
- Jorge L. Anaya-González
- Facultad de Ciencias de la Salud. Universidad Técnica del Norte. Imbabura, EcuadorUniversidad Técnica del NorteUniversidad Técnica del NorteImbaburaEcuador
- Facultad de Salud. Universidad Camilo José CelaUniversidad Camilo José CelaUniversidad Camilo José CelaImbaburaEcuador
| | - Francisco López-Muñoz
- Facultad de Salud. Universidad Camilo José CelaUniversidad Camilo José CelaUniversidad Camilo José CelaImbaburaEcuador
- Unidad de Neuropsicofarmacología. Instituto de Investigación Hospital 12 de Octubre. Madrid, EspañaInstituto de Investigación Hospital 12 de OctubreInstituto de Investigación Hospital 12 de OctubreMadridEspaña
| | - Erlen Carmona-Álvarez Builla
- Facultad de Ciencias de la Salud. Universidad Técnica del Norte. Imbabura, EcuadorUniversidad Técnica del NorteUniversidad Técnica del NorteImbaburaEcuador
| | - Adriana E. Miniet-Castillo
- Facultad de Ciencias de la Salud. Universidad Técnica del Norte. Imbabura, EcuadorUniversidad Técnica del NorteUniversidad Técnica del NorteImbaburaEcuador
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22
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Hernández-Fustes OJ, Hernández-Cossio O, Arteaga-Rodríguez C. [Neurocysticercosis, its clinical and tomographic correlation]. Rev Neurol 2023; 76:313. [PMID: 37102256 PMCID: PMC10478143 DOI: 10.33588/rn.7609.2022277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Indexed: 04/28/2023]
Affiliation(s)
- Otto J. Hernández-Fustes
- Departamento de Clínica Médica. Universidade Federal do ParanáUniversidade Federal do ParanáUniversidade Federal do ParanáCuritibaBrasil
| | | | - Carlos Arteaga-Rodríguez
- Departamento de Medicina. Universidade Positivo. Curitiba, BrasilUniversidade PositivoUniversidade PositivoCuritibaBrasil
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Sharma K, Uniyal R, Garg RK, Verma R, Paliwal VK, Malhotra HS, Sharma PK, Kumar N, Pandey S, Rizvi I. Does Calcified Neurocysticercosis Affect Migraine Characteristics and Treatment Responsiveness? A Case-Control Study. Am J Trop Med Hyg 2022; 107:1190-1195. [PMID: 36216323 PMCID: PMC9768286 DOI: 10.4269/ajtmh.22-0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/25/2022] [Indexed: 12/30/2022] Open
Abstract
Recently, inflammation and free-radical release has been described in the surrounding brain parenchyma of seemingly inert calcified lesions of neurocysticercosis. These free radicals can induce migraine by stimulating calcitonin gene-related peptide release. This stipulated mechanism led us to hypothesize that calcified neurocysticercosis may increase migraine severity. This case-control study included patients (migraine with calcified neurocysticercosis) and control subjects (migraine without calcified neurocysticercosis) in a 1:1 ratio. Headache frequency, visual analog scale (VAS) score, and Migraine Disability Assessment (MIDAS) score were assessed at baseline and at the end of 3 months. To compare treatment responsiveness between patients and control subjects, we treated both groups identically so that difference in treatment would not confound the results. Each group comprised 78 patients. Baseline headache frequency (11.3 ± 3.3 versus 7.9 ± 3.4), VAS score (7.5 ± 1.1 versus 6.0 ± 1.2), and MIDAS score (15 ± 7.6 versus 9.6 ± 4.5) were significantly greater in patients than control subjects. Interestingly, the change from baseline to the end of 3 months in headache frequency (6.0 ± 1.7 versus 2.8 ± 1.4), VAS score (2.6 ± 0.02 versus 1.4 ± 0.01), and MIDAS score (8.3 ± 5.0 versus 3.6 ± 2.0) were significantly greater in patients than control subjects. Our study emphasizes that calcified lesions of neurocysticercosis are not inert, and cause an increase in the frequency and severity of migraine attacks. Interestingly, these patients also showed a better response to treatment with amitriptyline, possibly resulting from its anti-inflammatory action. Further studies are warranted to explore possible inflammatory mechanisms in calcified neurocysticercosis, which influences migraine physiology.
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Affiliation(s)
- Kamini Sharma
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Ravi Uniyal
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Ravindra Kumar Garg
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Rajesh Verma
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Vimal Kumar Paliwal
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | | | - Praveen Kumar Sharma
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Neeraj Kumar
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Shweta Pandey
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Imran Rizvi
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
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Panda PK, Ramachandran A, Sharawat IK, Sherwani P, Bhat NK. Comparison of Seizure Characteristics and Recurrence Rates in Children with Viable Parenchymal Neurocysticercosis and Tuberculoma in India. Am J Trop Med Hyg 2022; 107:833-840. [PMID: 36037862 PMCID: PMC9651522 DOI: 10.4269/ajtmh.21-1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/20/2022] [Indexed: 11/07/2022] Open
Abstract
Inflammatory granulomas (neurocysticercosis [NCC] and tuberculomas) are important causes of seizures in children and adults in the developing world. Although several studies have explored seizure characteristics individually in patients with either NCC or tuberculoma, none has compared the seizure recurrence rate between them. This study included patients aged 5 to 18 years with viable parenchymal NCC or tuberculomas who had completed regular follow-up of at least 12 months at a tertiary institute in India. Their baseline seizure and electroencephalographic characteristics, antiseizure medications (ASMs), and breakthrough seizure rates at 12, 24, and 52 weeks were noted. A total of 103 and 54 patients with active NCC and tuberculomas respectively were included. The number of patients who had at least one breakthrough seizure at 12, 24, and 52 weeks in both groups was comparable (P = 0.32, 0.27, and 0.13), and the vast majority were controlled on monotherapy (98% cases in each group). The proportion of patients who required an increase in the dose or change of ASMs or polytherapy, the proportion of children who had status epilepticus at or before 12 months, abnormal electroencephalogram at 12 months, and calcified and active granuloma in neuroimaging at 12 months were also comparable between the two groups (P > 0.05 for all). The number of patients who had ASM-related adverse events and discontinued ASM due to serious adverse events was comparable between both groups, except for hepatotoxicity in the tuberculoma group. The predictors for breakthrough seizures that were found to be statistically significant in the NCC group were the presence of perilesional edema in the baseline magnetic resonance imaging (P = 0.02) and more than five active granulomas (P = 0.01); predictors in the tuberculoma group were the presence of severe perilesional edema causing midline shift in the baseline magnetic resonance imaging (P = 0.01) and more than five active granulomas (P = 0.04). The recurrence rates of breakthrough seizures over the next 12 months in newly detected cases of active NCC and tuberculomas were comparable.
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Affiliation(s)
- Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Aparna Ramachandran
- Department of Neurology, IQRAA International Hospital & Research Centre, Kozhikode, Kerala, India
| | - Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Poonam Sherwani
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, India
| | - Nowneet Kumar Bhat
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
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Kus J, Panah E, Rosenblum J, Bashir M. Isolated Spinal Cord Neurocysticercosis. J Radiol Case Rep 2022; 16:1-7. [PMID: 36353290 PMCID: PMC9629800 DOI: 10.3941/jrcr.v16i10.4543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The incidence of neurocysticercosis is increasing in the US. The diagnosis is primarily made based on imaging findings, with clinical presentation and epidemiological exposure also playing a role. The differential diagnosis for neurocysticercosis (NCC) is extensive, and being able to differentiate between these conditions on imaging is crucial to making a proper diagnosis. Herein we present a case of a 37-year-old female who presented with lower extremity weakness and was found to have isolated spinal NCC. In this article, we will discuss the symptoms and imaging findings of neurocysticercosis to help guide diagnosis and management.
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Affiliation(s)
- Joseph Kus
- Department of Radiology, Loyola University Medical Center, Maywood, IL, USA
- Correspondence: Joseph Kus, MD, Loyola University Medical Center, 2160 S 1st Ave, Department of Radiology c/o Linda Schomer, Maywood, IL 60153, USA, ()
| | - Elnaz Panah
- Department of Pathology, Loyola University Medical Center, Maywood, IL, USA
| | - Jordan Rosenblum
- Department of Radiology, Loyola University Medical Center, Maywood, IL, USA
| | - Mariah Bashir
- Department of Radiology, Loyola University Medical Center, Maywood, IL, USA
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26
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Borella LFM, Leitao DS, Narvaez EDO, Ramos MDC, Reis F. High-resolution vessel wall imaging in human neurocysticercosis with leptomeningitis. Arq Neuropsiquiatr 2022; 80:765-766. [PMID: 36254450 PMCID: PMC9685821 DOI: 10.1055/s-0042-1755214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Affiliation(s)
- Luiz Fernando Monte Borella
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Radiologia, Campinas SP, Brazil
| | - Dafny Soares Leitao
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Infectologia, Campinas SP, Brazil
| | | | - Marcelo de Carvalho Ramos
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Infectologia, Campinas SP, Brazil
| | - Fabiano Reis
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Radiologia, Campinas SP, Brazil
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Anaya-González JL, López-Muñoz F, Carmona-Álvarez Builla E, Miniet-Castillo AE. [Correlation between clinical and tomographic variables in patients with neurocysticercosis. A study in a cohort of patients in Sierra Norte, Ecuador, between 2019 and 2020]. Rev Neurol 2022; 74:383-391. [PMID: 35698433 DOI: 10.33588/rn.7412.2021365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Neurocysticercosis (NCC) is the most frequent parasitic disease in the central nervous system of humans. OBJECTIVE to establish the correlation between clinical and tomographic variables in patients with neurocysticercosis in the neurology consultation of Hospital San Vicente de Paul and Hospital IESS Ibarra, during the year 2020. PATIENTS AND METHODS descriptive, correlational and cross-sectional research. POPULATION AND SAMPLE 93 patients. The information was collected in the neurology consultation. Clinical and imaging criteria were used for diagnosis. Odds Ratio (OR; 95% CI) was calculated. For multivariate analysis, binary logistic regression models were used. Statistical significance was considered when the value of p <0.05. SYMPTOMS headache (77.4%), epilepsy (41.9%). Tomographic findings: size < 1 cm (67.7%), single lesion (54.8%), supratentorial (93.5%). There were several clinical / tomographic correlations in the bivariate analysis, the presence of epilepsy was associated with lesions of size >1 cm (OR: 9.65; 95% CI: 3.48-26.7), the vesicular + ventricular colloidal stage + nodular (OR: 3.90; 95% CI: 1.64-9.28) and parenchymal topography (OR: 5.03; 95% CI: 2.03-12.4) (p < 0.05). In the multivariate analysis, epilepsy was not associated with tomographic aspects such as the size, stage and topography of the cysticerci (p < 0.05). Headache and reduced muscle strength were associated with parenchymal topography and stage of lesions respectively (p < 0.05). CONCLUSIONS Despite having a wide clinical spectrum, the presence of epilepsy, headache, and reduced muscle strength seem to be the most representative manifestations, so their inclusion in the development of prognostic scores should be evaluated, which allow evaluating the approach diagnostic and evolutionary in subsequent research.
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Affiliation(s)
- J L Anaya-González
- Universidad Camilo José Cela (UCJC), Madrid, España
- Universidad Técnica del Norte, Imbabura, Ecuador
| | - F López-Muñoz
- Instituto de Investigación Hospital 12 de Octubre, Madrid, España
- Universidad Camilo José Cela, Madrid, España
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Zapata WR, Yang SY, Bustos JA, Gonzales I, Saavedra H, Guzman C, Pretell EJ, Garcia HH. Quality of life in patients with symptomatic epilepsy due to neurocysticercosis. Epilepsy Behav 2022; 131:108668. [PMID: 35483205 PMCID: PMC9879681 DOI: 10.1016/j.yebeh.2022.108668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/23/2022] [Accepted: 03/08/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Neurocysticercosis (NCC) is a common cause of late-onset epilepsy worldwide, but there is still minimal information regarding its impact on a patient's quality of life. This study evaluated quality of life in a series of patients with epilepsy secondary to NCC using the QOLIE (Quality of Life in Epilepsy)-31 questionnaire. METHODOLOGY This cross-sectional study included 155 Peruvian patients between 16 and 70 years of age with epilepsy due to viable intraparenchymal NCC, who enrolled in two trials of anti-parasitic treatment during the period 2006-2011. The QOLIE-31 questionnaire was applied before the onset of anti-parasitic treatment. The associations between QOLIE-31 scores, sociodemographic characteristics, clinical, and neuroimaging data were analyzed with Kruskal-Wallis test and generalized linear models (GLM). RESULTS The average QOLIE-31 score was 55.8 (SD ± 7.6), with 119 individuals (76.8%) scoring in the poor quality-of-life category. Generalized tonic-clonic seizures and secondarily generalized epileptic seizures were associated with a lower QOLIE-31, as well as a low level of education with a value of p = 0.05. There were no associations between QOLIE-31 scores and other variables such as sex, age, antiepileptic medication, number of parasitic cysts, and number of compromised brain regions. On multivariate analysis, a greater number of generalized epileptic seizures maintained a statistically significant association with detrimental QOLIE-31 scores. CONCLUSION Quality of life is affected in NCC, mainly in relation to the number of prior generalized epileptic seizures.
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Affiliation(s)
- Willy R Zapata
- Departamento de Epilepsia, Instituto Nacional de Ciencias Neurológicas, Lima, Peru.
| | - Susan Y Yang
- School of Medicine, Trinity College Dublin, Dublin, Ireland; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Javier A Bustos
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Isidro Gonzales
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Herbert Saavedra
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Carolina Guzman
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | | | - Hector 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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Ganaraja HV, Mahadevan A, Saini J, Nalini A, Pal PK, Satishchandra P, Netravathi M. Disseminated Cysticercosis in Indian Scenario - Experience from a Teaching University Hospital. Neurol India 2022; 70:1032-1040. [PMID: 35864635 DOI: 10.4103/0028-3886.349634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Neurocysticercosis (NCC) due to Taenia Solium is a major public health problem. Our objective was to study patients with disseminated cysticercosis (DCC) who had NCC in the brain along with an additional site in the body and assess their clinical, radiological profile, and response to therapy. MATERIALS AND METHODS A chart review of DCC with a high lesion load of NCC ≥20 (DNCC) in the brain was performed. RESULTS Sixteen (M:F = 13:3) patients were diagnosed with DNCC with a mean age of presentation of 35.1 ± 14.2 years. Headache was the predominant symptom, followed by seizures (93.75%), vomiting (43.75%), behavioral disturbances (31.25%), fever (12.5%), encephalopathy (12.5%), visual disturbances (6.25%), and muscle pain and limb weakness (6.25%). CT brain showed multiple active parenchymal cysts in all, and calcifications in 68.75%. MRI brain revealed involvement of cortex and subcortical structures in all, followed by cerebellum (81.25%) and brainstem (75%). Intramedullary spinal lesion was observed in 12.5% cases. Albendazole with steroids was used in 15 patients. In 93.3% patients, there was complete improvement in seizures; 12.5% subjects had persistent memory and behavioral abnormalities. One subject required decompressive craniectomy; mortality was observed in two subjects. CONCLUSIONS We hereby report one of the largest case series on disseminated cysticercosis with a high lesion load of NCC in the brain. A comprehensive clinical, imaging, therapeutic response with repeat imaging and long-term follow-up has given us a better understanding of this difficult-to-treat neurological disorder. We suggest cautious use of anti-parasitic therapy under the cover of corticosteroids to prevent irreversible neurological sequelae.
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Affiliation(s)
- Harikrishna V Ganaraja
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Anita Mahadevan
- Department of Neuropathology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Neuroradiology (NIIR), National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Atchayaram Nalini
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pramod K Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Parthasarathy Satishchandra
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Manjunath Netravathi
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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30
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Paramjit E, Singh P. Neurocysticercosis: new insight into an old pathology. BMJ Case Rep 2022; 15:e249107. [PMID: 35288434 PMCID: PMC8921848 DOI: 10.1136/bcr-2022-249107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/03/2022] Open
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31
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Lopes M, Ferreira M, Ramos I, Melo Freitas P. Neurocysticercosis: a contemporary presentation of the neuroimaging main stages. BMJ Case Rep 2022; 15:e247927. [PMID: 35140100 PMCID: PMC8830162 DOI: 10.1136/bcr-2021-247927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mariana Lopes
- Department of Infectious Diseases, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Mafalda Ferreira
- Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Isabel Ramos
- Department of Infectious Diseases, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Pedro Melo Freitas
- Neuroradiology Unit - Medical Imaging Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
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Bhattarai S, Thapa L, Maharjan AM, Shrestha AM, Shrestha S, Ghimire MR, Upadhyaya S, Thapa M. Impact of Albendazole Therapy on Clinical and Radiological Outcomes at One Month in Patients with Active Solitary Neurocysticercosis Patients. Kathmandu Univ Med J (KUMJ) 2022; 20:61-65. [PMID: 36273293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background Cerebral neurocysticerosis is a common parasitic disease of human nervous system but evidence on duration of albendazole therapy and their outcomes in this condition is inadequate Objective To evaluate the impact of varying duration of albendazole therapy on the clinical and radiological outcomes at one month in patients with active solitary neurocysticercosis. Method This is an interventional study conducted at Upendra Devkota Memorial National Institute of Neurological and Allied sciences, Bansbari over 1 year (2017 March - 2018 February). One hundred eighteen patients with new onset seizure secondary to active solitary cysticercal granuloma either received albendazole therapy for 1, 3, 9 or 21 days with the usual care or only received the usual care. Clinical and radiological outcomes were observed at one month follow-up. The difference in the proportion of the outcome measures between intervention and control groups were assessed using chi-square test. Result Our study included 118 patients with male predominance of 61.9%. Albendazole therapy for 3, 9 and 21 days reduced headache by 57.2%, 70.0% and 63.1% respectively which was higher than those with 1-day therapy or without the therapy. This difference in the proportion was statistically significant at p=0.001. Though seizure recurrence also declined but the difference was not significant (p=0.406) between groups. However, at one-month follow-up, majority of patients who received albendazole for 9 days (14, 70%) and 21 days (14, 73.7%) had normal lesion, while most calcified lesion (21, 67.7%) was observed in those who did not receive albendazole therapy. The difference between lesion among the groups was significant (p < 0.001). Conclusion Albendazole therapy in patients with active solitary neurocysticercosis for 9 days is as effective as 21 days and better than 3 days in headache control and lesion dissolution but seizure control could be achieved irrespective of the treatment.
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Affiliation(s)
- S Bhattarai
- Department of Neurology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu, Nepal
| | - L Thapa
- Department of Neurology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu, Nepal
| | - A Ms Maharjan
- Department of Neurology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu, Nepal
| | - A M Shrestha
- Department of Neurology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu, Nepal
| | - S Shrestha
- Department of Neurology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu, Nepal
| | - M R Ghimire
- Department of Neurology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu, Nepal
| | - S Upadhyaya
- Department of Neurology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu, Nepal
| | - M Thapa
- Department of Neurology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu, Nepal
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Del Brutto OH, Garcia HH. The many facets of disseminated parenchymal brain cysticercosis: A differential diagnosis with important therapeutic implications. PLoS Negl Trop Dis 2021; 15:e0009883. [PMID: 34793447 PMCID: PMC8601456 DOI: 10.1371/journal.pntd.0009883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Neurocysticercosis (NCC), the infection of the nervous system by the cystic larvae of Taenia solium, is a highly pleomorphic disease because of differences in the number and anatomical location of lesions, the viability of parasites, and the severity of the host immune response. Most patients with parenchymal brain NCC present with few lesions and a relatively benign clinical course, but massive forms of parenchymal NCC can carry a poor prognosis if not well recognized and inappropriately managed. We present the main presentations of massive parenchymal NCC and their differential characteristics.
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Affiliation(s)
- Oscar H. Del Brutto
- School of Medicine, Universidad Espíritu Santo—Ecuador, Samborondón, Ecuador
| | - Hector H. Garcia
- Center for Global Health, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Perú
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
- * E-mail:
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Radhakrishnan DM, Bhasi A, Saurya S, Shree R, Kumar N. Spinal Intramedullary Neurocysticercosis An Unusual Cause of Paraparesis. J Assoc Physicians India 2021; 69:11-12. [PMID: 34585901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Divya M Radhakrishnan
- Assistant Professor, Department of Neurology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
| | - Ankith Bhasi
- Junior Resident, Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
| | - Saurya Saurya
- Junior Resident, Department of Radiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
| | - Ritu Shree
- Assistant Professor, Department of Neurology, Post Graduate Institute of Medical Education Research, Chandigarh
| | - Niraj Kumar
- Additional Professor, Department of Neurology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
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Ruíz Márquez MJ, Cabra Rodríguez R, Ruíz Márquez D. Reactivation of neurocysticercosis in patient under study on suspicion of dengue. Rev Esp Quimioter 2021; 34:162-163. [PMID: 33611883 PMCID: PMC8019458 DOI: 10.37201/req/128.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M J Ruíz Márquez
- María José Ruíz Márquez. UGC de Análisis Clínicos. Área de Gestión Sanitaria Norte de Huelva. Spain.
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Brusius CV, Bianchin MM, Mira JM, Frigeri T, Kruger M, Grudtner MC, Lenhardt R, Maschke S, Wolfsberger S. Single Burr-Hole Extended Transforaminal Approach for Concurrent Endoscopic Surgery in the Third Ventricle Posterior to the Foramen of Monro and Ventriculostomy: Clinical Series and Planning Steps. World Neurosurg 2021; 150:e1-e11. [PMID: 33582291 DOI: 10.1016/j.wneu.2021.01.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE For endoscopic surgery of third ventricular lesions posterior to the foramen of Monro that frequently require a third ventriculostomy during the same procedure, the extended transforaminal approach (ETFA) through the choroid fissure has been proposed. This study reports clinical results and provides anatomic background and guidelines for individual planning of a single burr-hole approach and a safe transchoroid entry zone. METHODS A retrospective review was undertaken of 25 cases of concurrent third ventricle surgery and third ventriculostomy via ETFA. Assessment was made of a safe transchoroidal entry zone on cadavers (6 hemispheres) and of planning guidelines on magnetic resonance imaging showing occlusive hydrocephalus (30 sides). RESULTS ETFA was feasible in all 25 cases. The safe transchoroid entry zone was sufficient in 16 cases; in 9 cases, additional transchoroid opening with transection of the anterior septal vein was required without clinical consequences. The anatomic study showed a safe transchoroid entry zone of 5 mm (3-6 mm) for posterior enlargement of the foramen of Monro. Individual planning on magnetic resonance imaging of patients with enlarged third ventricles showed an optimal burr-hole position 22 mm (10-30 mm) lateral to the midline and 8 mm (27 to -23 mm) precoronal; a foramen of Monro diameter of 7 mm (3-11 mm) and a safe transchoroid entry zone of 6 mm (3-12 mm). CONCLUSIONS According to our data, concurrent endoscopic surgery of third ventricular lesions posterior to the foramen of Monro and ventriculostomy are feasible through a single burr hole and a transchoroid extension of the transforaminal approach. Precise preoperative planning is recommended for anticipating the individual anatomic nuances.
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Affiliation(s)
- Carlos V Brusius
- Hospital Moinhos de Ventos, Porto Alegre, Brazil; Hospital de Santa Casa of Porto Alegre, Brazil.
| | | | - Juan M Mira
- Hospital Sanatorio CASMER-FEMI, Rivera, Uruguay
| | | | | | - Mauro Cesar Grudtner
- Department of Neurosurgery, Hospital Sao Jose, Jaragua do Sul, Santa Catarina, Brazil
| | | | - Svenja Maschke
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
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Sastry R, Moldovan K, Niu T. Headache, Confusion, and Somnolence in a 27-Year-Old Woman. JAMA 2020; 324:2097-2098. [PMID: 33034624 DOI: 10.1001/jama.2020.10167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Rahul Sastry
- Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Krisztina Moldovan
- Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Tianyi Niu
- Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
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McCleery E, Allen SE, Moyano LM, Gamboa R, Vilchez P, Muro C, Castillo Y, Dorny P, Garcia HH, O’Neal SE. Population Screening for Urine Antigens to Detect Asymptomatic Subarachnoid Neurocysticercosis: A Pilot Study in Northern Peru. Am J Trop Med Hyg 2020; 103:1125-1128. [PMID: 32602434 PMCID: PMC7470589 DOI: 10.4269/ajtmh.20-0196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/20/2020] [Indexed: 11/07/2022] Open
Abstract
Subarachnoid neurocysticercosis (SANCC) is a severe and progressive brain infection with Taenia solium. We performed a pilot study of noninvasive screening for SANCC in two endemic villages in northern Peru using a urine antigen screen followed by brain magnetic resonance imaging for participants with elevated levels of antigen. Among the 978 participants screened, we identified eight individuals with SANCC, many of whom were asymptomatic. This represents a minimum prevalence of 0.8% of SANCC, a level higher than expected based on prior studies, and a positive predictive value of 62% for our novel urine screening test. Future studies should confirm whether early detection and management improve clinical outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | - Pierre Dorny
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Hector H. Garcia
- Centro de Salud Global, Tumbes, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Seth E. O’Neal
- Oregon Health & Science University, Portland, Oregon
- Centro de Salud Global, Tumbes, Peru
- Portland State University, Portland, Oregon
| | - for the Cysticercosis Working Group in Peru
- University of California Davis, Sacramento, California
- Oregon Health & Science University, Portland, Oregon
- Centro de Salud Global, Tumbes, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
- Institute of Tropical Medicine, Antwerp, Belgium
- Portland State University, Portland, Oregon
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Hamamoto Filho PT, Moreira CAA, Generoso D, Alves JÚnior AC, Zanini MA. Experimental neurocysticercosis and demyelination. Arq Neuropsiquiatr 2020; 78:528-529. [PMID: 32725050 DOI: 10.1590/0004-282x20200034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 03/11/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Pedro Tadao Hamamoto Filho
- Universidade Estadual Paulista, Botucatu Medical School, Department of Neurology, Psychology and Psychiatry, Botucatu SP, Brazil
| | - Carlos Alexandre Aguiar Moreira
- Universidade Estadual Paulista, Botucatu Medical School, Department of Neurology, Psychology and Psychiatry, Botucatu SP, Brazil
| | - Diego Generoso
- Universidade Estadual Paulista, Botucatu Medical School, Department of Neurology, Psychology and Psychiatry, Botucatu SP, Brazil
| | - Aderaldo Costa Alves JÚnior
- Universidade Estadual Paulista, Botucatu Medical School, Department of Neurology, Psychology and Psychiatry, Botucatu SP, Brazil
| | - Marco Antônio Zanini
- Universidade Estadual Paulista, Botucatu Medical School, Department of Neurology, Psychology and Psychiatry, Botucatu SP, Brazil
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Ma L, Chen DC, Zou SY, Liu YY, Zhou LY, Xiu ZG. Epidemiological characteristics of hepatic echinococcosis, concurrent cerebral echinococcosis, and pulmonary echinococcosis in Ganzi County, Sichuan Province, China. Medicine (Baltimore) 2020; 99:e19753. [PMID: 32282737 PMCID: PMC7220390 DOI: 10.1097/md.0000000000019753] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Human echinococcosis has become a major public health problem in most parts of the world. The objective of this article was to study the demographics of patients with hepatic echinococcosis in Ganzi County to elucidate the main risk factors, as well as to report the concurrent prevalence of cerebral echinococcosis and pulmonary echinococcosis.We recruited 195 patients with hepatic echinococcosis from the Datongma area of Ganzi County from January 2018 to November 2018. The patients' demographics, living environments, supported medical resources, knowledge of echinococcosis prevention and control, and hygienic practices were investigated and analyzed. The prevalence of cerebral echinococcosis and pulmonary echinococcosis were also investigated.The data were analyzed to identify risk factors for human echinococcosis. Our analysis showed that the herding Tibetan population within the 20 to 60 age group, and females, in particular, were at the highest risk of human echinococcosis infection. Having stray dogs around habitations and intimate activities with dogs and livestock were also behavioral risk factors. People with poor health literacy and low educational qualifications had possible risks of infection. In terms of hygiene, not using tap water as the drinking water source and lack of medical staff were significantly correlated with echinococcosis prevalence. Four patients were diagnosed with cerebral echinococcosis. Among them, 1 patient had both cerebral echinococcosis and pulmonary echinococcosis.Possible high-risk factors for echinococcosis were being female, herding population, in the 20 to 60 age group, having stray dogs around habitations, having activities with dogs and livestock, having poor health literacy, having low educational qualifications, and not using tap water as a drinking water source. The detection rate for brain echinococcosis in patients with hepatic echinococcosis was high (2.05%). Effective preventive strategies should be implemented in epidemic areas. Head CT scans should be applied for early detection of cerebral echinococcosis to carry out the treatment.
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Affiliation(s)
- Li Ma
- Department of Urology, West China Hospital Sichuan University, Institute of Urology
| | - De-Cai Chen
- Endocrinology Department, West China Hospital Sichuan University
| | | | - Yan-Yi Liu
- Hospital Management Department, The First People's Hospital of Lognquanyi District, Chengdu
| | - Lin-Yong Zhou
- Hospital Management Department, People's Hospital of Ganzi County, Ganzi Tibetan Autonomous Prefecture
| | - Zhi-Gang Xiu
- Radiology, The First People's Hospital of Lognquanyi District, Chengdu, Sichuan, China
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da Silva Miranda CC, Fernandes Dos Santos CFS, Cordeiro de Medeiros AB. Neurocysticercosis Presenting as Acute Psychosis: An Unusual Case. Psychiatr Danub 2020; 32:445-446. [PMID: 33370750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Carolina Colaço da Silva Miranda
- Department of Psychiatry and Mental Health, Hospital Garcia de Orta, CDC Building - 1st Floor, Av. Torrado da Silva, 2805-267 Almada, Portugal
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Abstract
PURPOSE OF REVIEW This article discusses select helminthic parasitic infections that may affect the central nervous system and reviews the epidemiology, neurologic presentation, recommended diagnostic testing, and treatment approach to these infections. RECENT FINDINGS Emigration from and travel to areas endemic for helminthic infections that affect the nervous system has led to increased incidence of parasitic neurologic disease in developed countries, necessitating that neurologists be familiar with the diagnostic and therapeutic approach to these diseases. Evidence is emerging on the optimal treatment for neurocysticercosis, which varies based on the form of the disease in the nervous system. SUMMARY Parenchymal neurocysticercosis is a leading cause of acquired epilepsy worldwide, and extraparenchymal neurocysticercosis is responsible for many cases of hydrocephalus. Recognition of the different stages and locations of neurocysticercosis is essential for proper management. Similarly, schistosomiasis constitutes a major cause of myelopathy in endemic areas and requires prompt diagnosis and treatment to avoid permanent deficits.
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Affiliation(s)
- Nishanth Dev
- ESIC Medical College and Hospital, Faridabad, India
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Saporta-Keating SR, Simões EAF, Yu G, Federman S, Mirsky D, Dominguez SR, Chiu CY, Messacar K. A Child With Intermittent Headaches and Eosinophilic Meningitis. J Pediatric Infect Dis Soc 2018; 7:355-357. [PMID: 29438532 PMCID: PMC6276032 DOI: 10.1093/jpids/piy005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sara R Saporta-Keating
- Division of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
| | - Eric A F Simões
- Department of Epidemiology, Colorado School of Public Health, Aurora
| | - Guixia Yu
- Department of Laboratory Medicine, University of California San Francisco
- University of California San Francisco–Abbott Viral Diagnostics and Discovery Center
| | - Scot Federman
- Department of Laboratory Medicine, University of California San Francisco
- University of California San Francisco–Abbott Viral Diagnostics and Discovery Center
| | - David Mirsky
- Department of Radiology, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
| | - Samuel R Dominguez
- Division of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
| | - Charles Y Chiu
- Department of Laboratory Medicine, University of California San Francisco
- University of California San Francisco–Abbott Viral Diagnostics and Discovery Center
- Division of Infectious Diseases, Department of Medicine, University of California San Francisco
| | - Kevin Messacar
- Division of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
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Tao Y, Feng-Quan X, Yan W, Yu-Guang F, Jun D, Ting-Xia F. [Study on diagnosis of atypical cerebral cysticercosis]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2018; 30:424-427. [PMID: 30350507 DOI: 10.16250/j.32.1374.2018015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To analyze the characteristics of the results of serum immunological tests and brain CT image examinations of atypical cerebral cysticercosis patients, so as to provide the reference for improving the diagnosis of the disease. METHODS Totally 446 suspected cerebral cysticercosis patients were chosen as the study objects, all of them were given experimental treatment with praziquantel, and then the patients with atypical cerebral cysticercosis were diagnosed according to the treatment effect and review results of brain CT or MRI. Meanwhile, all the 446 patients were tested for serum specific IgG and IgG4 antibodies and cysticercus circulating antigen (CAg) by ELISA, McAb ELISA and PEG-ELISA respectively, and the IHA test was also performed. All the patients received the brain CT examinations. The test results were analyzed statistically and the test performances of the methods above-mentioned were calculated. RESULTS Among the 446 suspected cerebral cysticercosis patients, after the praziquantel treatment, there were 315 patients whose symptoms were alleviated, and they were diagnosed as atypical cerebral cysticercosis. Among the 446 suspected cerebral cysticercosis patients, the positive rates of specific IgG and IgG4 antibodies, and CAg were 15.47%, 15.02%, and 11.21% respectively, and the positive rate of IHA was 28.47% (χ2 = 52.45, P < 0.01). The brain CT examinations showed that there were 79.14% (353/446) of patients with suspected cysticercus foci. The sensitivities of ELISA, McAb-ELISA, PEG-ELISA, IHA test and brain CT examination (suspected cysticercus foci) for the diagnosis of atypical cerebral cysticercosis were 15.36%-96.82%, the specificities were 63.36%-99.24%, the positive predictive values were 86.40%-98.52%, the negative predictive values were 32.83%-98.25%, the positive likelihood ratios were 2.64-27.86, the negative likelihood ratios were 0.05-0.81, and the OR values were 7.16-52.80. The consolidation of the five tests above-mentioned showed the OR value was 108.00, which was 2 times of the OR value of CT examination. CONCLUSIONS Atypical cerebral cysticercosis is definitely diagnosed mainly by means of evaluating the effect of the diagnostic therapy (anti-cysticercus), and the serum immunological examinations and brain CT examination also have important reference values.
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Affiliation(s)
- Yu Tao
- Shandong Institute of Parasitical Diseases, Jining 272000, China
| | - Xu Feng-Quan
- Shandong Institute of Parasitical Diseases, Jining 272000, China
| | - Wang Yan
- Shandong Institute of Parasitical Diseases, Jining 272000, China
| | - Fu Yu-Guang
- Shandong Institute of Parasitical Diseases, Jining 272000, China
| | - Dai Jun
- Department of Immunology and Molecular Medicine, Jining Medical University, China
| | - Fu Ting-Xia
- Shandong Institute of Parasitical Diseases, Jining 272000, China
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Jolobe OMP. Neurocysticercosis versus disseminated intracranial tuberculoma. QJM 2018; 111:69. [PMID: 29040731 DOI: 10.1093/qjmed/hcx192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Oscar M P Jolobe
- From the Manchester Medical Society, Simon Building, Brunswick Street, Manchester M13 9PL, UK
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Affiliation(s)
| | - Rizwan Khan
- Great Western Hospitals NHS Foundation Trust, Acute Medicine, Swindon, UK
| | - Vinod Dibbur
- Great Western Hospitals NHS Foundation Trust, Acute Medicine, Swindon, UK
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Yadav K, Garg D, Kaushik JS, Vaswani ND, Dubey R, Agarwal S. Intramedullary Neurocysticercosis Successfully Treated with Medical Therapy. Indian J Pediatr 2017; 84:725-726. [PMID: 28466406 DOI: 10.1007/s12098-017-2353-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/10/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Kuldeep Yadav
- Department of Pediatrics, Pt B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, 124001, India
| | - Deepali Garg
- Department of Pediatrics, Pt B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, 124001, India
| | - Jaya Shankar Kaushik
- Department of Pediatrics, Pt B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, 124001, India.
| | - N D Vaswani
- Department of Pediatrics, Pt B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, 124001, India
| | - Rachana Dubey
- Department of Pediatrics, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, 452001, India
| | - Shalini Agarwal
- Department of Radiodiagnosis, Pt B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, 124001, India
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Cangalaya C, Bustos JA, Calcina J, Vargas-Calla A, Mamani J, Suarez D, Arroyo G, Gonzalez AE, Chacaltana J, Guerra-Giraldez C, Mahanty S, Nash TE, García HH. Radiological evolution of porcine neurocysticercosis after combined antiparasitic treatment with praziquantel and albendazole. PLoS Negl Trop Dis 2017; 11:e0005624. [PMID: 28575043 PMCID: PMC5470720 DOI: 10.1371/journal.pntd.0005624] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 06/14/2017] [Accepted: 05/04/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The onset of anthelmintic treatment of neurocysticercosis (NCC) provokes an acute immune response of the host, which in human cases is associated with exacerbation of neurological symptoms. This inflammation can occur at the first days of therapy. So, changes in the brain cysts appearance may be detected by medical imaging. We evaluated radiological changes in the appearance of brain cysts (enhancement and size) on days two and five after the onset of antiparasitic treatment using naturally infected pigs as a model for human NCC. METHODS AND RESULTS Contrast T1-weighted magnetic resonance imaging with gadolinium was performed before and after antiparasitic treatment. Eight NCC-infected pigs were treated with praziquantel plus albendazole and euthanized two (n = 4) and five (n = 4) days after treatment; another group of four infected pigs served as untreated controls. For each lesion, gadolinium enhancement intensity (GEI) and cyst volume were measured at baseline and after antiparasitic treatment. Volume and GEI quantification ratios (post/pre-treatment measures) were used to appraise the effect of treatment. Cysts from untreated pigs showed little variations between their basal and post treatment measures. At days 2 and 5 there were significant increases in GEI ratio compared with the untreated group (1.32 and 1.47 vs 1.01, p = 0.021 and p = 0.021). Cyst volume ratios were significantly lower at days 2 and 5 compared with the untreated group (0.60 and 0.22 vs 0.95, p = 0.04 and p = 0.02). Cysts with lower cyst volume ratios showed more marked post-treatment inflammation, loss of vesicular fluid and cyst wall wrinkling. CONCLUSION/SIGNIFICANCE A significant and drastic reduction of cyst size and increased pericystic enhancement occur in the initial days after antiparasitic treatment as an effect of acute perilesional immune response. These significant changes showed that early anthelmintic efficacy (day two) can be detected using magnetic resonance imaging.
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Affiliation(s)
- Carla Cangalaya
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Peru
- * E-mail:
| | - Javier A. Bustos
- Unidad de Cisticercosis, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Juan Calcina
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Ana Vargas-Calla
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Javier Mamani
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Diego Suarez
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Gianfranco Arroyo
- Unidad de Cisticercosis, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Armando E. Gonzalez
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Juan Chacaltana
- Departamento de Diagnóstico por imágenes, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Cristina Guerra-Giraldez
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Siddhartha Mahanty
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Theodore E. Nash
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Héctor H. García
- Unidad de Cisticercosis, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
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