Neurocysticercosis: a study of 177 cases from São José do Rio Preto, São Paulo, Brazil

Abstract

Interest in the function of subcortical structures in cognitive function has grown in the last decades. Such interest has increased after the advent of modern innovations in radiology techniques, which provide a better visualization of subcortical lesions, like computerized tomography (CT) and magnetic resonance imaging (MRI). Cortical blood flow and metabolism studies also brought a better understanding of diaschisis mechanisms in vivo and improved our knowledge about the pathophysiology of subcortical lesions. The purpose of this study was to identify language and/or speech alterations in patients with exclusively subcortical lesions and to establish a profile of such alterations. The author compared the profiles obtained from thalamic and non-thalamic lesions, trying to define some pathophysiologic mechanisms subjacent to the lesions.To achieve this purpose, the author studied a group of 16 patients (9 patients with basal ganglia and adjacent white matter pathways lesions and 7 patients with thalamic lesions), chosen on the basis of their CT scan findings, selected from the Emergency Room of Hospital das Clínicas of the University of São Paulo School of Medicine (USP) and Hospital Universitário (USP). All patients were submitted to CT scan in the acute stage of illness, 13 patients were submitted to MRI and 12 patients were submitted to single photon emission computerized tomography (SPECT), in order to evaluate cortical blood flow. Patients were also submitted to language evaluation, using the Boston Diagnostic Aphasia Examination, Boston Naming and Token Test. Seventeen normal subjects were evaluated by the same language batteries as a control group.Articulatory and motor disturbances predominated in the non-thalamic group, and language alterations were poor (only one third of the patients showed some language disturbance). There was no characteristic profile in this group.In the thalamic group, however, there was a higher incidence of language disabilities, specially naming disturbances (5 cases) and comprehension disturbances (4 cases). Articulatory disabilities were found in only one patient. There was a high prevalence of cortical flow disturbances in these patients, compromising classical cortical language areas (in the frontal and temporal lobes), making it difficult to exclude cortical dysfunction as a contributing factor to explain the alterations.In the thalamic aphasias, the author also concludes about the possibility of verbal memory and attentional mechanisms disturbances impairing primary language processing; such aspects deserve future studies.

Syringohydromyelia associated to therapeutic procedures for severe forms of neurocysticercoses: case report

“…Headaches as an isolated symptom occur in about 20% of the cases and intracranial hypertension in 15%. Meningitis is present in 8% and other clinical combinations are present in 2% 7,8 . Neurocysticercosis presenting cysts or calcification within the cerebral parenchyma are termed Cysticercus cellulosae and has the best prognosis with clinical treatment.…”

Clinical, epidemiological and laboratory criteria for the diagnosis of human cysticercosis in Brazilian patients

“…A diagnosis of suspected NCC is raised in all patients in the present study as the symptoms were suggestive but not specific for NCC. Maretti (1999) found positive values of 37.7 and 31% in ELISA and IFAT, respectively, in CSF samples from 177 pa-80 OEl¹ski Criteria for the diagnosis of human cysticercosis tients with NCC. The percentage of seropositive results, found by using ELISA and IFAT in the present study is equivalent to those described by Maretti (1999).…”

“…Maretti (1999) found positive values of 37.7 and 31% in ELISA and IFAT, respectively, in CSF samples from 177 pa-80 OEl¹ski Criteria for the diagnosis of human cysticercosis tients with NCC. The percentage of seropositive results, found by using ELISA and IFAT in the present study is equivalent to those described by Maretti (1999). Among the patients found to be seronegative by ELISA and IFAT, 78.7% presented inactive calcified cysticerci.…”