Updated evidence of the association between toxocariasis and epilepsy: Systematic review and meta-analysis

Abstract

ObjectiveTo gain further insight on the association between human toxocariasis and epilepsy in light of the new evidence in the last years.MethodsA systematic review was conducted without date and language restriction in the following electronic databases: MEDLINE (PubMed), Ingenta Connect, Science Direct (Elsevier), RefDoc, Scopus, HighWire, Scielo and the database of the Institute of Neuroepidemiology and Tropical Neurology of the Limoges University (IENT). Two investigators independently conducted the search up to November 2017. A pooled odds ratio (OR) was estimated using a random effects model. Meta-regression was conducted to investigate potential sources of heterogeneity.ResultsDatabase search produced 204 publications. Eleven case-control studies were included that were carried out in 13 countries worldwide. A total number of 4740 subjects were considered (2159 people with epilepsy and 2581 people without epilepsy). The overall pooled OR was 1.69 (95% CI 1.42–2.01) for the association between epilepsy and Toxocara spp. seropositivity. A positive association was constantly reported in the restricted analysis (WB as confirmatory or diagnostic test, younger population, and population–based studies). Meta-regression showed no statistically significant association between covariates and outcome.ConclusionThe updated meta-analysis provides epidemiological evidence of a positive association between Toxocara seropositivity and epilepsy. New surveys supported the association, mainly population-based studies. On this basis, health strategies to reduce the impact of Toxocara spp are strongly advised. Further research should be performed to understand the physiopathological mechanisms of toxocara-associated epileptogenesis.

Risk factors and prevalence of toxocariasis in pregnant women and diabetic patients compared to healthy adults in Ilam province, western Iran

“…In the present study, close contact with infected animal pets (dogs and cats) was significantly associated with positive toxocariasis in diabetic patients while liver and pancreatic disorders were reported among diabetic patients infected with larval (Choi et al, 2012[ 3 ]; Lee et al, 1976[ 12 ]). Although not sought for in the current study, but recent evidences revealed that toxocariasis with CNS involvement has significant neuropsychological impact on its victims (Luna et al, 2018[ 14 ]).…”

“…Toxocariasis is associated with animal pets and living in rural areas of the region. Further studies involving comprehensive neuropsychological evaluation of seropositive patients can be an important milestone in diagnosing neurotoxocariasis (Janecek et al, 2017[ 10 ]; Lawton and Sharma, 2017[ 11 ]; Luna et al, 2018[ 14 ]).…”

Human toxocariasis – A look at a neglected disease through an epidemiological ‘prism’

“…Involvement of the peripheral nervous system, reflected in radiculitis, inflammation of cranial nerves and/or skeletal muscles, is rarely recorded in humans (Finsterer and Auer, 2007). In a meta-analysis of published information/data representing 2159 people with epilepsy and 2581 people without epilepsy (Luna et al, 2018), it was shown that seropositivity to Toxocara was significantly associated with epilepsy (odds ratio [OR], 1.69; 1.42 to 2.01).…”

Prevalence of epilepsy and its association with exposure to Toxocara canis: A community-based, case–control study from rural Northern India

“…Furthermore, this study did not aim to estimate the prevalence of asymptomatic calcified lesions in the brain. In the meta-analysis,[2] there was a positive association between T. canis and epilepsy. Our results were similar to a previously published study from India.…”