Number and viability of parasite influence seizure frequency in children with neurocysticercosis.
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We investigated the relationship between CT findings - number and the viability phase of the parasites - and the seizure frequency in children with neurocysticercosis before and short-term after antiepileptic drug (AED) introduction. We only found a significant interaction between stage of parasitic infection and number of lesions on seizure frequency after AED treatment. Patients with more than five lesions on active or transitional stages had higher seizure frequency predicting a worse short-term prognosis. (+info)
A seroepidemiological study of human cysticercosis in West Cameroon.
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We studied the occurrence of human cysticercosis in 4993 individuals from three rural communities of Menoua Division, West Province of Cameroon. Circulating antigens of Taenia solium metacestodes were detected in 0.4%, 1.0% and 3.0% of the serum samples taken in Bafou, Bamendou and Fonakekeu, respectively, and examined using a monoclonal antibody-based enzyme-linked immunosorbent assay. This test detects only carriers of living cysticerci and gives thus a good idea of the presence of active cysticercosis. The percentage of persons infected with cysticercosis increased with age. Twenty-two of the 34 seropositives underwent computed tomography (CT) of the brain. Thirteen of them were CT-scan positive, which shows that neurocysticercosis was present in 59.1% of the tested seropositive persons. No living cysticerci were detected among 20 seronegative people. About 20.6% of the seropositives had a history of or current taeniasis against only 1.9% of the seronegatives. Based on these figures and on the data on porcine cysticercosis (prevalence: 11%) and human taeniasis (prevalence: 0.13%) collected in the same region, we conclude that T. solium cysticercosis is an endemic, but overlooked public health problem in West Cameroon. (+info)
Is neurocysticercosis a risk factor in coexistent intracranial disease? An MRI based study.
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BACKGROUND: Previous reports have suggested that neurocysticercosis is associated with glioma and Japanese encephalitis, and that it is a risk factor for stroke. OBJECTIVE: To determine if neurocysticercosis has a significant association with, or is a risk factor for, coexistent pathologies such as Japanese encephalitis, glioma, abscess, tuberculoma, or infarction. SUBJECTS: 10 350 patients from the hospital population who underwent 1.5 T cranial magnetic resonance imaging during the previous 12 years were evaluated for the presence of neurocysticercosis and coexisting pathology. DESIGN: Retrospective cohort analysis. RESULTS: The prevalence of neurocysticercosis in cases with dual pathology was significantly less than in a control group (1.1% v 8.3%; z = 11.05; p < 0.001, power of test = 1). Neurocysticercosis lesions were less common (p < 0.05) in the different subgroups of coexistent pathology than in the control group except in the case of Japanese encephalitis, where the difference was non-significant (z = 0.69, p = 0.49). The relative risk was less than 1 in all subgroups except Japanese encephalitis, where it was 1.23. The location of neurocysticercosis lesions and the presence of perilesional oedema did not affect coexistent lesion location or severity on a particular side (p = 0.413 and 0.623 for location and perilesional oedema, respectively). When the above factors were analysed separately in patients with Japanese encephalitis, they also did not affect coexistent lesion location or severity (p = 0.659 and 0.548, respectively). CONCLUSIONS: The coexistence of neurocysticercosis and other lesions may be an incidental observation in a few patients referred from areas of high prevalence and endemicity. It appears unlikely that neurocysticercosis is a risk factor for other intracerebral pathology. The location of neurocysticercosis lesions and whether or not there is surrounding perilesional oedema do not appear to affect the location or severity of coexisting lesions. (+info)
Similar diagnostic performance for neurocysticercosis of three glycoprotein preparations from Taenia solium metacestodes.
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The detection of antibodies to Taenia solium metacestodes is very important in the differential diagnosis of neurocysticercosis (NCC). In this study, an electroimmunotransfer blot (EITB) assay that uses an elaborate protocol with metacestode glycoproteins as antigens was compared with two other Western blots that use glycoproteins obtained using simpler methods, including an eluate from a lectin column, or the vesicular fluid (VF) of the parasite. The concordance between the three assays was 91% in patients with active NCC and 100% in patients with suspected NCC and previous documentation of negative serology. The specificities for the Western blots and the EITB assay were 98% and 100%, respectively (98% concordance). These data suggest that the simplest of these immunoassays, the one that uses the VF of T. solium metacestodes in a Western blot format, can be reliably used for the serologic diagnosis of NCC in developing countries where access to the EITB assay is difficult. (+info)
CC chemokines mediate leukocyte trafficking into the central nervous system during murine neurocysticercosis: role of gamma delta T cells in amplification of the host immune response.
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According to a previous report, the degree of the host immune response highly correlates with severity of the disease in the murine model for neurocysticercosis. In wild-type mice, Mesocestoides corti infection induced a rapid and extensive accumulation of gamma delta T cells and macrophages in the brain. NK cells, dendritic cells, alpha beta T cells, and B cells were also recruited to the brain but at lower levels. In contrast, gamma delta T-cell-deficient mice exhibited decreased cellular infiltration and reduced central nervous system (CNS) pathology. To understand the mechanisms of leukocyte recruitment into the CNS, chemokine expression was analyzed in infected brains in the present study. MCP-1 (CCL2), MIP-1 alpha (CCL3), and MIP-1 beta (CCL4) were up-regulated within 2 days after M. corti infection. Protein expression of RANTES (CCL5), eotaxin (CCL11), and MIP-2 was detected later, at 1 week postinfection. Correlating with the decreased cellular infiltration, delta chain T-cell receptor-deficient (TCR delta(-/-)) mice exhibited substantially reduced levels of most of the chemokines analyzed (with the exception of eotaxin). The results suggest that gamma delta T cells play an important role in the CNS immune response by producing chemokines such as MCP-1 and MIP-1 alpha, enhancing leukocyte trafficking into the brain during murine neurocysticercosis. (+info)
Prolonged perilesional edema after treatment of parenchymal neurocysticercosis: methotrexate as a corticosteroid-sparing agent.
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Treatment of neurocysticercosis with larvicidal agents is commonly complicated by seizures and transient neurologic deficits as a result of the host immune response to dying cysts. We report a case in which treatment with high-dose praziquantel resulted in prolonged perilesional edema requiring use of corticosteroids and corticosteroid-sparing agents for >1 year, suggesting a role for methotrexate in the management of this condition. (+info)
Endoscopic approach to fourth ventricle cysticercosis.
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Neurocysticercosis is the most frequently observed parasitosis of the central nervous system worldwide. The fourth ventricle is the most frequent site of intraventricular infestation, a location that carries a higher risk for CSF blockage and intracranial hypertension due to CSF blockage. A great number of patients become shunt dependent which carries a poorer prognosis. We report on a case of a patient with symptomatic obstructive hydrocephalus due to cysticercus in the fourth ventricle where an endoscopic approach via a frontal burr hole was performed. Although there is no consensus in the literature for the optimal treatment of this disease, this method seemed adequate for treatment of fourth ventricle cysticercosis in patients with hydrocephalus, aqueductal and foramen of Monro dilatations. (+info)
Cauda-conus syndrome resulting from neurocysticercosis.
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A 60-year-old male, presented with insidious onset, gradually progressive, burning paresthesia over the saddle area, sphincteric disturbance, impotence and paraparesis. Investigations revealed a ring-enhancing lesion in the conus medullaris suggestive of neurocysticercosis. This was supported by quantitative enzyme-linked immunosorbant assay from purified cell fraction of taenia solium cysticerci. On treatment with steroids he showed marked improvement. (+info)