Clinical Manifestations Associated with Neurocysticercosis: A Systematic Review

Abstract

BackgroundThe clinical manifestations of neurocysticercosis (NCC) are poorly understood. This systematic review aims to estimate the frequencies of different manifestations, complications and disabilities associated with NCC.MethodsA systematic search of the literature published from January 1, 1990, to June 1, 2008, in 24 different electronic databases and 8 languages was conducted. Meta-analyses were conducted when appropriate.ResultsA total of 1569 documents were identified, and 21 included in the analysis. Among patients seen in neurology clinics, seizures/epilepsy were the most common manifestations (78.8%, 95%CI: 65.1%–89.7%) followed by headaches (37.9%, 95%CI: 23.3%–53.7%), focal deficits (16.0%, 95%CI: 9.7%–23.6%) and signs of increased intracranial pressure (11.7%, 95%CI: 6.0%–18.9%). All other manifestations occurred in less than 10% of symptomatic NCC patients. Only four studies reported on the mortality rate of NCC.ConclusionsNCC is a pleomorphic disease linked to a range of manifestations. Although definitions of manifestations were very rarely provided, and varied from study to study, the proportion of NCC cases with seizures/epilepsy and the proportion of headaches were consistent across studies. These estimates are only applicable to patients who are ill enough to seek care in neurology clinics and likely over estimate the frequency of manifestations among all NCC cases.

Longer epilepsy duration and multiple lobe involvement predict worse seizure outcomes for patients with refractory temporal lobe epilepsy associated with neurocysticercosis

“…Seizures are the most frequent manifestations of NCC (70-90%) followed by headache (38%), focal deficits (16%), and signs of intracranial hypertension (ICH, 12%). Other manifestations occur in fewer than 10% of symptomatic patients 13 . Recent Brazilian investigations have reported that NCC seems to contribute to or even cause refractory epileptic seizures associated with hippocampal sclerosis 8,9 .…”

“…The clinical manifestations of NCC are variable and strongly depend on the number, type, size, location, and stage of development of the cysticerci, as well as the immune response of the host against the parasite 12,13,14,15,16 . Seizures are the most frequent manifestations of NCC (70-90%) followed by headache (38%), focal deficits (16%), and signs of intracranial hypertension (ICH, 12%).…”

Complexities in using sentinel pigs to study Taenia solium transmission dynamics under field conditions

“…The main clinical feature, however, lies in human cysticercosis. The development of cysticerci in the central nervous system (neurocysticercosis, NCC) is shown to be an important cause of acquired epilepsy and other neural disorders in endemic regions (Carabin et al, 2011). In recent years, it has become clear that the disease complex is not only of importance in the African and American continents (Flisser et al, 2006), but also in Asian countries, such as Nepal (Joshi et al, 2004;Rajshekhar et al, 2003).…”

Racemose neurocysticercosis - neuroimaging guide the diagnosis

“…En una revisión sistemática de estudios publicados entre 1990 y 2008, Carabin, et al, encontraron, en orden de frecuencia, las siguientes manifestaciones clínicas: convulsiones o epilepsia (79 %), cefalea (40 %), déficit neurológico focal (16 %) y signos de hipertensión intracraneal (12 %), en tanto que, en menos del 10 % de los casos, se presentaron ataxia, alteraciones visuales, parálisis de nervios craneales, síntomas meníngeos y las alteraciones del estado mental (8,9).…”