Clinical heterogeneity of human neurocysticercosis results from complex interactions among parasite, host and environmental factors

Abstract

Human neurocysticercosis (NC) is endemic in most countries of Latin America, Asia and Africa and is re-emerging in some industrialized nations. Both within and among endemic countries, NC is very variable in its clinical and radiological features, as well as in the intensity of the immuno-inflammatory reactions of the hosts. This review, focusing on the Mexican experience, describes and interprets the heterogeneity of NC as the result of different combinations among factors associated with the parasite, host and environment. The review may serve to foster similar descriptive efforts in other endemic areas of the world in order to facilitate the identification of the distinct factors that participate in the complex pathogenesis and diverse clinical outcomes of NC. In particular, it is necessary to understand the precise physiopathology of the inflammatory reaction associated with NC, as inflammation is one of the characteristics of those NC cases that are clinically more severe and less responsive to current treatments. Devising new medical interventions through the use of molecular regulators of the innate and adaptive immune responses of the host is a largely unexplored approach that could improve the existing forms of treatment.

Recurrencia/persistencia de neoplasia intraepitelial cervical posterior a cono LEEP en el Instituto Nacional de Enfermedades Neoplásicas

“…De los datos de pacientes analizados se encontró que la distribución por sexo coincide con lo reportado en la literatura internacional, siendo el sexo femenino el más frecuente (9,10) . Esto puede deberse a que en zonas consideradas endémicas las personas dedicadas a labor doméstica (cocineras y amas de casa) suelen estar más expuestas (11) .…”

“…Está descrito el inicio de manifestaciones clínicas en este estadio, ya que posiblemente fueron asintomáticos o tuvieron molestias mínimas en los estadios anteriores. Este hecho ocurre más a menudo en países considerados endémicos para la enfermedad (10,15) . El número de síntomas fue significativamente más frecuente en el estadio coloidal.…”

Racemose neurocysticercosis - neuroimaging guide the diagnosis

“…Fleury, et al, han propuesto que la heterogeneidad de las manifestaciones clíni-cas de la neurocisticercosis en humanos depende de la interacción entre factores relacionados con el parásito, como su localización, estadio, tamaño y número de quistes, con factores del huésped, como la edad, el sexo, la respuesta inmunitaria y genética, y con factores ambientales, como la frecuencia y la intensidad de la exposición, las prácticas culturales y la situación socioeconómica (12).…”

Neurocysticercosis, familial cerebral cavernomas and intracranial calcifications: differential diagnosis for adequate management

“…An interesting confounding aspect is that there are few studies showing familial aggregation of NC 28,34 and, on this situation, it would be reasonable to use MRI scan to establish the differential diagnosis with FCCM. As the familial form of cavernomas is more prone to develop epilepsy 24 and also characterized by multiple brain lesions, often calcified on the CT scan, ranging from a few to uncountable ones, the different nature of the two diseases certainly raises the importance the correct diagnosis.…”