Calcified neurocysticercosis among patients with primary headache

Brutto, Oscar H. Del; Brutto, Victor J. Del

doi:10.1177/0333102411433043

Cited by 41 publications

(32 citation statements)

References 15 publications

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“…Moreover, parenchymal calcifications can be associated with focal edema by the time of a seizure or a headache episode, likely reflecting periodical exposure of trapped antigens to the host's immune system and subsequent inflammation. [1][2][3][4] An association between calcified NCC and hippocampal atrophy has also been suggested based on studies of patients with refractory epilepsy, but the actual prevalence and relevance of this association is largely unknown. [5][6][7][8] Here, we report the results of a populationbased and a nested case-control study aimed to assess the prevalence of calcified cysticerci and its association with hippocampal atrophy in community-dwelling elderly persons living in Atahualpa, a rural Ecuadorian village where NCC is endemic.…”

Section: Introductionmentioning

confidence: 99%

Calcified Neurocysticercosis Associates with Hippocampal Atrophy: A Population-Based Study

Brutto¹,

Salgado²,

Lama³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Calcified neurocysticercosis has been associated with hippocampal atrophy in patients with refractory epilepsy, but the relevance of this association in the population at large is unknown. We assessed calcified cysticerci and its association with hippocampal atrophy in elderly persons living in Atahualpa, an Ecuadorian village endemic for neurocysticercosis. All Atahualpa residents 60 years of age were invited to undergo computed tomography/magnetic resonance imaging for neurocysticercosis detection. Twenty-eight (11%) out of 248 enrolled persons had calcified cysticerci (case-patients) and were matched 1:1 by age, sex, and years of education to individuals without neurocysticercosis on computed tomography/magnetic resonance imaging (controls). Four case-patients and none of the controls had epilepsy (P = 0.134). Cognitive performance was similar across both groups. The Scheltens' medial temporal atrophy scale was used for hippocampal rating in case-patients and matched controls without neurocysticercosis. Mean score in the Scheltens' scale was higher in case-patients than in controls (P 0.001). Atrophic hippocampi were noticed in 19 case-patients and five controls (P = 0.003). Atrophy was bilateral in 11 case-patients and unilateral in eight. All case-patients with unilateral hippocampal atrophy had at least one ipsilateral calcification. This study shows an association between calcified cysticerci and hippocampal atrophy and raises the possibility of an inflammation-mediated hippocampal damage as the responsible mechanism for these findings.

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Section: Introductionmentioning

confidence: 99%

Calcified Neurocysticercosis Associates with Hippocampal Atrophy: A Population-Based Study

Brutto¹,

Salgado²,

Lama³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…La información clínica y epidemiológica orientan el diagnóstico, pero éste es primariamente por neuro-imagen, TC y RM, presentando mayor sensibilidad esta última, pero con la desventaja de ser más costosa y no detectar correctamente las calcificaciones 79,80 .…”

Section: Discussionunclassified

Validez de tres métodos de inmuno-diagnóstico de neurocisticercosis: revisión sistemática de la literatura con meta-análisis 1960-2014

Cardona‐Arias

Carrasquilla-Agudelo

Restrepo-Posada

2017

Rev. chil. infectol.

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“…The fact that the headaches probably developed and worsened in temporal relationship with neurocysticercosis and alleviated after specific treatment argues in favour of neurocysticercosis-induced migraine (ICHD-3 9.1.3). Several population- [3,4] and clinic-based [8-10] studies have shown that primary headaches are more prevalent in subjects with neurocysticercosis. Neurocysticercosis with occipital lesions can even mimick migraine with visual aura [11-13], which was not the case in our patient.…”

Section: Discussionmentioning

confidence: 99%

“…Primary headaches (migraine and tension-type headache) seem to be more prevalent in patients with neurocysticercosis [3,4]. It is not known, however, if there is a pathophysiological link between the 2 conditions or they are just comorbid because of their high prevalence.…”

Section: Introductionmentioning

confidence: 99%

Cerebral neurocysticercosis mimicking or comorbid with episodic migraine?

et al. 2014

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BackgroundNeurocysticercosis is a major cause of neurological symptoms in developing countries. We report a case of cerebral neurocysticercosis presenting as episodic migraine without aura, with clinico-radiological correlations and discuss the possible causal influence of neurocysticercosis on the pathomechanisms of migraine.Case presentationWe report a 24 year-old male consulting for a one year history of recurrent headaches. He described bilateral frontal and/or temporal attacks of throbbing headache, moderate to severe in intensity, worsened by head movements and accompanied by nausea, photophobia and phonophobia. Attacks lasted between 12 and 60 hours if untreated. He never had symptoms suggestive of a migraine aura or an epileptic seizure. Headache attacks progressively increased in frequency to up to 5 to 7 severe attacks per month. On taking history, the patient reported having consumed undercooked porcine meat. Physical examination was unremarkable. A brain CT scan showed two contiguous occipital cystic lesions with ring enhancement and surrounding edema suggestive of cerebral neurocysticercosis. On laboratory work-up, blood serology for cysticercal antibodies was positive. Full blood count, erythrocyte sedimentation rate, c - reactive protein level, human immunodeficiency virus serology, liver and hepatic function were all normal. Albendazole (1000 mg/day) and prednisolone (60 mg/day) were prescribed for seven days. The patient was examined again two and six months after the end of his treatment and there was a significant reduction in headache severity and frequency.ConclusionWe propose that in our patient the occipital neurocysticercosis lesions cause migraine without aura-like attacks via inflammation in the surrounding brain parenchyma leading to sensitization of the trigemino-vascular system. We cannot rule out, however, the possibility that our patient has a genetic predisposition for migraine without aura and that the fortuitous association of neurocysticercosis is simply an aggravating factor of his migraine.

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Calcified neurocysticercosis among patients with primary headache

Abstract: There is a relationship between calcified neurocysticercosis and primary headache disorders. It is possible that periodic remodeling of cysticercotic calcifications, with liberation of antigens to the brain parenchyma, contributes to the occurrence of headache in these patients.

Cited by 41 publications

References 15 publications

Calcified Neurocysticercosis Associates with Hippocampal Atrophy: A Population-Based Study

Calcified Neurocysticercosis Associates with Hippocampal Atrophy: A Population-Based Study

Validez de tres métodos de inmuno-diagnóstico de neurocisticercosis: revisión sistemática de la literatura con meta-análisis 1960-2014

Cerebral neurocysticercosis mimicking or comorbid with episodic migraine?

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