Headache and Cysticercosis in Ecuador, South America

Abstract

Intractable headaches have been described as the presenting complaint of many patients with T. solium neurocysticercosis. We conducted a house-to-house neuroepidemiological survey of 2,723 residents of an Andean community, known to be endemic for this infection. Migraine headaches were confirmed in 187 cases (68.7 per thousand), and tension headaches were diagnosed in 77 cases (28.3 per thousand). Fifty-seven migraine sufferers accepted computed tomography examination, and in 19 it revealed neurocysticercosis. In 11 out of 52 migraineurs who had their blood drawn, electron immunotransfer blot testing (EITB) was positive for anticysticercal antibodies. In a computer-generated random sample of this community, 109 headache-free individuals were examined by CT, and 87 had EITB. Of the 109 subjects examined by CT, 14 were positive for cysticercosis. Of the 87 individuals tested by EITB, 7 were positive. A statistically significant difference between the symptom-free general population and the migraine patients was obtained for both CT (odds ratio 3.39, P < 0.005) and EITB (odds ratio 3.07, P < 0.05) diagnosis of neurocysticercosis. Neurocysticercosis appears to be a significant risk factor for the presentation of migraine-type headaches in areas endemic for T. solium infection.

The global burden of migraine: measuring disability in headache disorders with WHO's Classification of Functioning, Disability and Health (ICF)

“…Nevertheless, recent studies from Brazil, Chile and Ecuador show that headache is highly prevalent in these countries and imposes a large economic burden on healthcare systems stretched to their limits. As in developed countries, migraine and chronic tension-type headache are the most common subtypes of headache disorders in South America [32][33][34][35][36]. Tekle Haimanot reported that "literature on prevalence and health burden in Africa is scanty" [37].…”

Case-control study of seropositivity for cysticercosis in Cuenca, Ecuador.

“…4 Much of the research on T. solium cysticercosis has focused on determining prevalence rates, assessing the accuracy of diagnostic methods, and comparing therapeutic regimens. [5][6][7] These investigations have established that neurocysticercosis has public health significance because of its medical and economic impact on both humans and livestock. Operational research is needed to define interventions to limit these parasites.…”

CC Chemokines Mediate Leukocyte Trafficking into the Central Nervous System during Murine Neurocysticercosis: Role of γδ T Cells in Amplification of the Host Immune Response

“…Neurocysticercosis (NCC) is the most common parasitic disease of the human central nervous system (CNS) and is caused by the presence of Taenia solium metacestodes in the brain (19,57,72,74). Seizures are the most common clinical manifestation associated with NCC (20,73), and less common symptoms include headache, increased intracranial pressure, and altered mental state (18,20,60,65). CNS infection with Mesocestoides corti has been used as a model for NCC (12).…”