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RESUMO -A cisticercose é grave problema de saúde pública em várias regiões da Ásia, África e América Latina. Os estudos epidemiológicos baseados na freqüência de casos nos serviços especializados de neurologia, neurocirurgia, tomografia computadorizada, nas necrópsias e nos estudos soroepidemiológicos não permitem a avaliação da real prevalência populacional. O presente estudo teve como objetivo a análise da prevalência da cisticercose no município de Ribeirão Preto, através da notificação compulsória implantada em caráter pioneiro no Brasil. O coeficiente de prevalência foi de 54 casos/100000 habitantes, no período de 20-outubro-1992 a 31-de-dezembro de 199S. Os resultados indicaram, adicionalmente, que a cisticercose não está sob controle no nosso meio pois 21% dos casos notificados apresentavam a forma ativa. A notificação compulsória revelou ser recurso valioso para o estudo epidemiológico da cisticercose, permitindo, adicionalmente, o mapeamento das áreas mais afetadas para melhor direcionamento das estratégias de prevenção. PALAVRAS-CHAVE: cisticercose, Taenia solium, epidemiologia, prevalência, notificação compulsória. Compulsory notification of cysticercosis in Ribeirão Preto -SP, BrazilABSTRACT -Cysticercosis is a severe public health problem in several regions of Asia, Africa and Latin America. Epidemiologic studies based on the frequency of cases observed in specialized neurology, neurosurgery and computed tomography services, at autopsy and in seroepidemiologic studies do not permit the determination of the true prevalence of the disease in the population. The objective of the present study was to investigate the prevalence of cysticercosis by compulsory notification. The coefficient of prevalence was 54 cases/100000 inhabitants in the municipality of Ribeirão Preto. The results also indicated that cysticercosis is not under control in our region since 21% of cases presented the active form of the disease. Compulsory notification proved to be a valuable resource for the epidemiologic study of cysticercosis, also permitting the mapping of more affected areas for a better direction of prevention strategies.KEY WORDS: cysticercosis, Taenia solium, epidemiology, prevalence, compulsory notification.A cisticercose humana, infestação pela forma larvária da Taenia solium, é grave problema de saúde pública em várias regiões da Ásia, África e América Latina, particularmente nos países em desenvolvimento. Nestes, a precariedade das condições sanitárias e o baixo nível sócio-econômico-cultural aliam-se na persistência de sua disseminação. Embora possa acometer os mais diversos órgãos, o envolvimento do sistema nervoso central (SNC) é a forma mais grave da cisticercose. Pela estimativa da Organização Mundial da Saúde, a neurocisticercose (NCC) é responsável por 50000

Anticysticercal therapy has been marked by intense controversy. Recent descriptions of spontaneous resolution of parenchymal cysticercosis with benign evolution, risks of complications and reports of no long-term benefits have reinforced the debate over the usefulness and safety of anticysticercal therapy. High interindividual variability and complex pharmacological interactions will require the close monitoring of plasma concentrations of ALB and PZQ metabolites in future trials. Given the relative scarcity of clinical trials, more comparative interventional studies - especially randomized controlled trials in long-term clinical evolution - are required to clarify the controversy over the validity of parasitic therapy in patients with NCC.

Extraparenchymal neurocysticercosis has an aggressive course because cysts in the cerebrospinal fluid compartments induce acute inflammatory reactions. The relationships between symptoms, imaging findings, lesion type and location remain poorly understood. In this retrospective clinical records-based study, we describe the clinical symptoms, magnetic resonance imaging features, and cyst distribution in the CSF compartments of 36 patients with extraparenchymal neurocysticercosis. Patients were recruited between 1995 and 2010 and median follow up was 38 months. During all the follow up time we found that 75% (27/36) of the patients had symptoms related to raised intracranial pressure sometime, 72.2% (26/36) cysticercotic meningitis, 61.1% (22/36) seizures, and 50.0% (18/36) headaches unrelated to intracranial pressure. Regarding lesion types, 77.8% (28/36) of patients presented with grape-like cysts, 22.2% (8/36) giant cysts, and 61.1% (22/36) contrast-enhancing lesions. Hydrocephalus occurred in 72.2% (26/36) of patients during the follow-up period. All patients had cysts in the subarachnoid space and 41.7% (15/36) had at least one cyst in some ventricle. Cysts were predominantly located in the posterior fossa (31 patients) and supratentorial basal cisterns (19 patients). The fourth ventricle was the main compromised ventricle (10 patients). Spinal cysts were more frequent than previously reported (11.1%, 4/36). Our findings are useful for both diagnosis and treatment selection in patients with neurocysticercosis.

-The objective of this study was to analyze different immunoglobulins classes (IgG, IgM, IgE and IgA) against Cysticercus cellulosae in the cerebrospinal fluid (CSF), through enzyme linked immunosorbent assay (ELISA), correlating them to clinical and tomographic profiles in patients with neurocysticercosis (NCC). Eighty-five specimens of CSF were obtained from 43 cases with NCC (26 with the active form and 17 with the inactive form) and from 42 patients with other neurological diseases. The inactive form of NCC presented a profile in CSF similar to the group without NCC. The active form of NCC presented elevation of specific immunoglobulins (IgG, IgM, IgE, and IgA) in decreasing order, with the highest values being detected among the cases with intraventricular cysts, or with inflammation signs in CSF or in those with multiple clinical manifestations. The highest sensitivity and specificity were obtained with ELISA-IgG (88.5% and 93.2%, respectively). This study confirmed the importance of ELISA in the immunologic diagnosis of NCC.