Clinical presentation of neurocysticercosis-related epilepsy

Unique Characteristics of Epilepsy Development in Neurocysticercosis

“…23,[36][37][38] The clinical presentation of seizures in NCC patients is likely impacted by whether the patients have multiple or single lesions, new-onset seizures, or established epilepsy, and whether or not they have been treated with antiparasitic medications. 39,40 Despite this clinical heterogeneity, multiple studies have confirmed that the most common seizure types associated with NCC are focal (occurring in 22-61% of NCC patients with new-onset seizures) and secondarily generalizedfocal seizures (15-61% of subjects). 39,41 Various studies have evaluated for an association between characteristics of NCC lesions and seizure semiology (clinical signs and symptoms), with mixed results.…”

“…39,40 Despite this clinical heterogeneity, multiple studies have confirmed that the most common seizure types associated with NCC are focal (occurring in 22-61% of NCC patients with new-onset seizures) and secondarily generalizedfocal seizures (15-61% of subjects). 39,41 Various studies have evaluated for an association between characteristics of NCC lesions and seizure semiology (clinical signs and symptoms), with mixed results. In some studies, the frontal lobe lesions were more likely to present with focal seizures, whereas the temporal lesions and those in the degenerating stage were more likely to secondarily generalize.…”

“…Inflammation is thought to lead to epileptogenesis either by causing gliosis and/or by causing persistent areas of bloodbrain barrier dysfunction. 39 As evidence to support an association between the inflammatory response and epileptogenesis, subjects with active epilepsy due to NCC, compared with infected subjects without epilepsy, have 1) higher serum levels of blood-brain barrier breakdown molecules (MMP-9) and increase in proinflammatory cytokines (tumor necrosis factor [TNF]-α, interferon-γ, and interleukin [IL] 1-β), 2) increased expression of lymphocyte adhesion molecules, and 3) increased likelihood of mutations in the Toll-like receptor 4 that lead to an increased Th1 (pro-inflammatory) response (Figure 1). 19,20,57,58 Finally, a strong serologic response (³ 4 bands) 8,59 to parasite antigen on NCC EITB was associated with both epilepsy development and with a more severe course once epilepsy was established.…”

Extraparenchymal neurocysticercosis: a challenge in treatment and in clinical management

“…In P-NCC the parasite tends to be destroyed probably by effective host immunity and in most cases evolves with mild or absence of symptoms. Epilepsy, the most important symptom in P-NCC, can generally be well controlled using anti-epileptic drugs (Duque and Burneo, 2017). However, it has been reported that the evolution can be improved by cysticidal treatment.…”

Comparação entre diferentes sequências de ressonância magnética na detecção de calcificações em pacientes portadores de neurocisticercose

“…NCC, apesar de assintomática em muitos casos, devido a sua alta carga endêmica, constitui problema de saúde pública nas regiões afetadas, sendo responsável por contribuir com doenças neurológicas e psiquiátricas tais como epilepsia, declínio cognitivo, cefaleia, depressão, delirium e outras, gerando enorme custo financeiro e inestimável custo social [3][4][5][6] . Apesar disso, ainda permanece relativamente negligenciada pelas instituições públicas e pela indústria farmacêutica [7][8][9] .…”