Long-term follow-up of patients with neurocysticercosis and the development of seazures

Abstract

Neurocysticercosis (NCC) is one of the most common causes of new onset seizures in young adults and even in infants; it is also one of the most important infectious etiologies of the central nervous system in developing countries, causing long-term sequelae such as epilepsy, dementia and hydrocephalus. To evaluate clinical cases of neurocysticercosis (NCC), correlating entry symptoms, epidemiological history, diagnostic methods, imaging, antigenic titles of ELISA (enzyme linked inmunosorvent) in serum and cerebrospinal fluid (CSF) and long-term sequelae caused by infection. A descriptive, chronological, 1744 NCC cases registered at the institution under hospital management with the same protocol since 1989 until 2012, with clinical inclusion criteria, imaging, epidemiological and laboratory; drug treatment with antihelmintics, corticosteroids and anticonvulsants; EEG monitoring with images and control of 3, 6 and 12 months after treatment. Total distribution of 58.7% male, 75.3% of cases diagnosed before 40 years of age, a mean age of 29.08 for men, 25.96 for women. Entry symptoms: Seizures (91.68%), headaches (4.58%) and focal deficit signs (1.83%). Type of seizure: Focal with secondary generalization (45.60%) and tonic-clonic generalized. Positive ELISA in serum (61.46%) and (36.41%) in CSF respectively (p=0.047) TAC was positive in 74.13% of cases. MRI 25.86% and EEG were abnormal in 45.9%. Localization: intraparenchimatous multiple: 40.99% of cases.26.20% in frontal lobe and 21.27% in parietal lobe. Lesion type: 34.74% vesicular with scolex, 19.5% coloid. 6.76% calcified cyst and 21.27% mixed forms. Four or more lesions were associated with Intraparenchimatous multiple. 20.6% acquired recurrent crisis (epilepsy) (p<05). In our setting, the NCC in developing countriesis a major cause of epilepsy patients within working age and even in infancy; it continues to be an endemic problem of regional health therefore the direct costs are not only from medical and surgical management, but the consequences have alsoa negative socioeconomic impact. Early diagnosis and treatment limit the appearance of complications and late sequelae such as symptomatic epilepsy. The burden of epilepsy for families is very important.