Cysticercosis as a major cause of epilepsy in Peru

Abstract

In countries where cysticercosis is endemic, the proportion of epilepsy due to cysticercosis is not well documented. To investigate the association between cysticercosis and epilepsy, we used the enzyme-linked immunoelectrotransfer blot (EITB) assay to detect serum antibodies to Taenia solium in 498 consecutive outpatients at a neurology clinic in Lima, Peru. Every patient was classified as epileptic (n = 189) or non-epileptic (n = 309) after neurological, and where possible electroencephalographic, examination. A substantially higher proportion of epileptic than nonepileptic patients was seropositive in the EITB (22 [12%] vs 8 [3%], p < 0·00l). 19% of epileptic patients born outside Lima, 20% of those with late-onset epilepsy, and 29% of patients with both these characteristics were seropositive. Thus, in Peru, cysticercosis is an important aetiological factor for epilepsy.

Seroprevalence of Taenia solium infections in Croatian patients presenting with epilepsy

“…Studies based on hospital series have reported that 50% of the 100 patients studied in Mexico have neurocysticercosis as the main cause of late-onset epilepsy (Medina et al, 1990). In a large series studied in Colombia and Peru where EITB method was used, cysticercosis was proven as the cause of epilepsy in 14% and 12% of the cases, respectively (Garcia et al, 1993, Palacio et al, 1998. It must be noted that there are very few studies on the neurocysticercosis in Europe.…”

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

“…Increased seropositivity among family members of individuals with neurocysticercosis has been shown before in previous investigations in rural communities of Peru, Mexico, and Guatemala. 4,8,11 However, the earlier studies have focused on the prevalence of cysticercosis in rural areas and communities with lower socio-economic status. [8][9][10][11] These studies reported a seroprevalence of human cysticercosis of 8% in Peru, 4 10.8% in Mexico, 8 and from 10% to 17% in Guatemala.…”

“…4,8,11 However, the earlier studies have focused on the prevalence of cysticercosis in rural areas and communities with lower socio-economic status. [8][9][10][11] These studies reported a seroprevalence of human cysticercosis of 8% in Peru, 4 10.8% in Mexico, 8 and from 10% to 17% in Guatemala. 11 Our study demonstrates a high background rate of seropositivity for cysticercosis, 3.8%, among an urban, middle to upper-middle class population, suggesting that socioeconomic status does not seem to mitigate against seropositivity in a region that is hyperendemic for T. solium taeniasis and cysticercosis.…”

“…In humans, the T. solium larvae commonly migrate and develop into cysticerci in the central nervous system (CNS) (neurocysticercosis), but they may also be found in subcutaneous tissue, muscle, the eye, and in other parts of the body. 4 The infection of the brain parenchyma by the larvae causes inflammation and creates cysts that can grow and cause mononuclear infiltrates, reactive astrogliosis, and cerebral edema, with possible displacement of neural structures. 3 The signs and symptoms depend on the localization of the cysts and whether they are alive, dying, or dead and calcified.…”

“…Epilepsy and intracranial hypertension are the most common sequelae. 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.…”