Epilepsy and neurocysticercosis in an Andean community

Cruz, Marcelo E.; Schantz, Peter; Cruz, I; Espinosa, Patricio; Preux, Pierre‐Marie; Cruz, Ãlvaro A.; Benítez, Washington; Tsang, Victor C. W.; Fermoso, J; Dumas, Michel

doi:10.1093/ije/28.4.799

Cited by 95 publications

(62 citation statements)

References 23 publications

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“…This finding is in contrast with the observation by Cruz et al (1999) who found a higher proportion of female epileptics with positive Ab-Elisa results and who attributed it to food handling activities and their relationship with infection with cysticerci.…”

Section: Discussioncontrasting

confidence: 99%

Neurocysticercosis and epilepsy in Cameroon

Zoli

Nguekam

Shey-Njila

et al. 2003

Transactions of the Royal Society of Tropical Medicine and Hygi

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Abstract:The frequency of Taenia solium cysticercosis was studied in a series of 504 epileptic patients from 3 rural localities in the West and North-west provinces of Cameroon using ELISA both for circulating antigen (Ag-Elisa) and antibody detection (Ab-Elisa). T. solium antigens were detected in the sera of 1.2% of the epileptics whereas specific antibodies against the parasite were present in 44.6% of patients. Significantly more seropositives in Ab-Elisa were recorded in Batibo than in Bandjoun and Batibo whereas a borderline significant difference was recorded with increasing age. Furthermore, 50% of patients with late-onset epilepsy showed antibodies against cysticercosis. T. solium cysticercosis appears to be an important cause of epilepsy in Cameroon.

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Section: Discussioncontrasting

confidence: 99%

Neurocysticercosis and epilepsy in Cameroon

Zoli

Nguekam

Shey-Njila

et al. 2003

Transactions of the Royal Society of Tropical Medicine and Hygi

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“…The most noticeable tip of this iceberg consists of people who harbor established, symptomatic central nervous system (CNS) disease-that is, neurocysticercosis. Below this tier is a larger population with established cysticercosis infection outside the CNS or in the CNS but without discernible symptoms, [7][8][9][10] and below this, there are many more people who were exposed to failed infections, but became seropositive. The presence of extremely high seroprevalence of Taenia solium antibodies in disease-endemic populations and relatively few symptomatic cases of neurocysticercosis was assumed to be a result of a largely asymptomatic infected human population, with minimal changes in prevalence over time.…”

mentioning

confidence: 99%

“…This could also explain the discrepant finding of high background levels of putatively inactive, calcified brain lesions in seronegative controls. [8][9][10] The incidence of exposure or infection must therefore be much higher than was previously suspected in order to balance the effect of transient antibody reactions and still maintain an equilibrium of high prevalence levels. The relationship between the transient antibody and exposure, current infection, or the development of immunity to future infection remains to be elucidated.…”

mentioning

confidence: 99%

Short report: transient antibody response in Taenia solium infection in field conditions-a major contributor to high seroprevalence.

Garcı́a

González²,

Gilman³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

110

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Abstract. The discordance between extremely high seroprevalence of Taenia solium antibodies in disease-endemic populations, relatively few symptomatic cases of neurocysticercosis, and high background levels of putatively inactive brain lesions (mainly calcifications) in seronegative controls have confused researchers, clinicians, and epidemiologists in the last decade. We reviewed longitudinal serologic data from general population serosurveys in 3 different diseaseendemic areas of Peru and Colombia and found that ϳ40% of seropositive people were seronegative when resampled after 1 year (3 surveys) or after 3 years (1 survey). Transient antibodies may have significant implications for the epidemiology of and immunity to this disease. Taenia solium cysticercosis is the main cause of acquired epilepsy in developing countries. 1 During the past 10 years, testing with the highly specific (100%) and sensitive (98%) enzyme-linked immunoelectrotransfer blot assay (EITB, Western blot) 2 showed unexpectedly high seroprevalence levels of antibodies to T. solium in populations of diseaseendemic areas. [3][4][5][6] As more population-based survey data became available, it is clear that human taeniasis-cysticercosis resembles an ''iceberg'' with 3 tiers. The most noticeable tip of this iceberg consists of people who harbor established, symptomatic central nervous system (CNS) disease-that is, neurocysticercosis. Below this tier is a larger population with established cysticercosis infection outside the CNS or in the CNS but without discernible symptoms, 7-10 and below this, there are many more people who were exposed to failed infections, but became seropositive. The presence of extremely high seroprevalence of Taenia solium antibodies in disease-endemic populations and relatively few symptomatic cases of neurocysticercosis was assumed to be a result of a largely asymptomatic infected human population, with minimal changes in prevalence over time.However, recent findings by our group challenge this view. We found that ϳ40% of seropositive people become seronegative in a short time-that is, Յ 1 year. The first survey that showed this phenomenon was conducted in 1993 in Monterredondo, a coastal village in Peru. A village-wide sampling covering 40% of all inhabitants showed a prevalence of 16% (76 of 482) for serum antibodies to T. solium by EITB. One year later, 373 people from the same village were sampled again, and this time the prevalence was 27% (99 of 373). These 373 participants included 209 newly sampled people, 57 (27%) of which were found to be positive by EITB. Among the 164 people who had been previously surveyed, 36 of 145 (25%) who were seronegative 1 year before were now seropositive, and 13 of 19 (68%) of those who were seropositive remained positive, whereas the other 6 (32%; 95% confidence interval [CI], 11-52) seroconverted to negative. These data showed that a large number of villagers had been newly infected and that a significant proportion of seropositive people became seronegative within 1 year.A few ye...

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“…Epileptic seizures were followed by headaches in 27.7% of people [58]. Headache in people with NCC can be acute or chronic, and presents as tension-type or migraine-like episodes [98,99]. Headache can also indicate raised intracranial pressure [90].…”

Section: Staging Pathology and Clinical Characteristics Of Neurocystmentioning

confidence: 99%