Occasional resolution of multiple parenchymal brain calcifications in patients with neurocysticercosis

Quiroz, Luis Jean Pierre Meneses; Gonzáles, Isidro; Pretell, E. Javier; Saavedra, Herbert; Garcı́a, Héctor H.

doi:10.1212/cpj.0000000000000144

Cited by 7 publications

(1 citation statement)

References 7 publications

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“…Another unexpected finding was the similar prevalence of patients with NCC across different age groups with the exception of those younger than 30 years of age. Since calcifications are permanent lesions except in very rare cases, 42 new infections should result in a cumulative effect increasing prevalence in older ages. Moreover, in the present series, the mean number of calcifications per patient did not increase with advancing age, suggesting that reinfections in already infected individuals were unlikely.…”

Section: Discussionmentioning

confidence: 99%

On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: A large‐scale, computed tomography–based population study in rural Ecuador

Brutto

Arroyo²,

Brutto

et al. 2017

Epilepsia

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SUMMARY Objective Using a large-scale population-based study, we aimed to assess prevalence and patterns of presentation of neurocysticercosis (NCC) and its relationship with epilepsy in community-dwellers aged ≥20 years living in Atahualpa (rural Ecuador). Methods In a three-phase epidemiological study, individuals with suspected seizures were identified during a door-to-door survey and an interview (Phase I). Then, neurologists evaluated suspected cases and randomly selected negative persons to estimate epilepsy prevalence (Phase II). In Phase III, all participants were offered non-contrast CT for identifying NCC cases. The independent association between NCC (exposure) and epilepsy (outcome) was assessed by the use of multivariate logistic regression models adjusted for age, sex, level of education and alcohol intake. CT findings were subsequently compared to archived brain MRIs in a sizable subgroup of participants. Results Of 1,604 villagers aged ≥20 years, 1,462 (91%) were enrolled. Forty-one persons with epilepsy (PWE) were identified, for a crude prevalence of epilepsy of 28 per 1,000 population (95% C.I.: 20.7 – 38.2). A head CT was performed in 1,228 (84%) out of 1,462 participants, including 39 of 41 PWE. CT showed lesions consistent with calcified parenchymal brain cysticerci in 118 (9.6%) cases (95% C.I.: 8.1% – 11.4%). No patient had other forms of NCC. Nine of 39 PWE, as opposed to 109 of 1,189 participants without epilepsy, had NCC (23.1% versus 9.2%, p=0.004). This difference persisted in the adjusted logistic regression model (OR: 3.04; 95% C.I.: 1.35 – 6.81; p=0.007). Significance This large CT-based study demonstrates that PWE had three times the odds of having NCC than those without epilepsy, providing robust epidemiological evidence favoring the relationship between NCC and epilepsy.

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Section: Discussionmentioning

confidence: 99%

On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: A large‐scale, computed tomography–based population study in rural Ecuador

Brutto

Arroyo²,

Brutto

et al. 2017

Epilepsia

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A multistate joint model for interval‐censored event‐history data subject to within‐unit clustering and informative missingness, with application to neurocysticercosis research

Zhang

Kelvin

Carpio

et al. 2020

Statistics in Medicine

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We propose a multistate joint model to analyze interval‐censored event‐history data subject to within‐unit clustering and nonignorable missing data. The model is motivated by a study of the neurocysticercosis (NC) cyst evolution at the cyst‐level, taking into account the multiple cysts phases with intermittent missing data and loss to follow‐up, as well as the intra‐brain clustering of observations made on a predefined data collection schedule. Of particular interest in this study is the description of the process leading to cyst resolution, and whether this process varies by antiparasitic treatment. The model uses shared random effects to account for within‐brain correlation and to explain the hidden heterogeneity governing the missing data mechanism. We developed a likelihood‐based method using a Monte Carlo EM algorithm for the inference. The practical utility of the methods is illustrated using data from a randomized controlled trial on the effect of antiparasitic treatment with albendazole on NC cysts among patients from six hospitals in Ecuador. Simulation results demonstrate that the proposed methods perform well in the finite sample and misspecified models that ignore the data complexities could lead to substantial biases.

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New understanding about the relationship among neurocysticercosis, seizures, and epilepsy

Carpio

Romo

Hauser

et al. 2021

Seizure

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Occasional resolution of multiple parenchymal brain calcifications in patients with neurocysticercosis

Cited by 7 publications

References 7 publications

On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: A large‐scale, computed tomography–based population study in rural Ecuador

On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: A large‐scale, computed tomography–based population study in rural Ecuador

A multistate joint model for interval‐censored event‐history data subject to within‐unit clustering and informative missingness, with application to neurocysticercosis research

New understanding about the relationship among neurocysticercosis, seizures, and epilepsy

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