Unique Characteristics of Epilepsy Development in Neurocysticercosis

Abstract

The parasitic helminth infection neurocysticercosis (NCC) is the most common cause of adult-acquired epilepsy in the world. Despite the serious consequences of epilepsy due to this infection, an in-depth review of the distinct characteristics of epilepsy due to neurocysticercosis has never been conducted. In this review, we evaluate the relationship between NCC and epilepsy and the unique characteristics of epilepsy caused by NCC. We also discuss recent advances in our understanding of NCC-related epilepsy, including the importance of anti-inflammatory therapies, the association between NCC and temporal lobe epilepsy, and the recent discovery of biomarkers of severe epilepsy development in individuals with NCC and seizures.

The Association between Neurocysticercosis and Epilepsy

“…According to Herrick et al, 1 "NCC is the most common cause of adult-acquired epilepsy in the world." This statement is not true.…”

“…6,7 Indeed, this Task Force warned that the high proportion attributed to NCC should be interpreted with caution, as these studies examined prevalent cases of epilepsy and were limited by low availability of diagnostic tools to detect other causes of epilepsy in the communities studied. 8 Herrick et al 1 affirm that "several studies have demonstrated a benefit of antiparasitic treatment in reducing the frequency of seizures in subjects with NCC." This is also debatable.…”

“…I read with interest the review “Unique Characteristics of Epilepsy Development in Neurocysticercosis,” published by Herrick et al 1 Neurocysticercosis (NCC) is a neglected zoonotic disease of high public health impact that is a cause of unacceptable morbidity and mortality. 2 Epilepsy is one of the most common neurological disorders of the brain, and it is also a public health imperative because it carries neurological, cognitive, psychological, and social consequences, and contributes substantially to the world’s burden of disease.…”

“…According to Herrick et al, 1 “NCC is the most common cause of adult-acquired epilepsy in the world.” This statement is not true. The authors based their statement on cross-sectional studies, most of them addressed to determine the prevalence of epilepsy, and some with serious methodological flaws, such as establishment of the diagnosis of NC by serological tests (electroimmunotransfer blot).…”

“…Herrick et al 1 affirm that “several studies have demonstrated a benefit of antiparasitic treatment in reducing the frequency of seizures in subjects with NCC.” This is also debatable. A Cochrane review found no significant difference when albendazole was used compared with no treatment for recurrence of seizures in people with viable parenchymal cysts.…”