Palmer Bret Sheldon
Barts & The London, Queen Mary's School of Medicine & Dentistry, University of London, United Kingdom.
Seizure. 2007 Dec;16(8):657-63. doi: 10.1016/j.seizure.2007.05.010. Epub 2007 Jun 28.
A meta-analysis was performed on three case controlled studies which examined the relationship between latent toxoplasmosis gondii infection in the immunocompetent host and cryptogenic epilepsy. Further comparison was also made by examining the seroprevalence of toxoplasmosis rates for 17 various countries, cities or regions against the prevalence rates for epilepsy in those regions.
The results for the meta-analysis showed a log-odds ratio of 4.8 which approximates to a similar relative risk, (CI 2.6 to 7.8), with CI for all three studies being above 1. Seroprevalence rates for toxoplasmosis and prevalence rates of epilepsy showed a strong association (p<0.001).
The prevalence of toxoplasmosis is an important factor in the prevalence of epilepsy with a probable link in the cryptogenic epilepsies. An area with a reduced burden of toxoplasmosis will also have a reduced burden of epilepsy. Neuropathophysiology findings from various studies show a common physical relationship of microglial nodule formation in Toxoplasma gondii infection and epilepsy. This analysis raises the possibility that one of the many causes of epilepsy may be an infectious agent, or that cryptogenic epilepsy may be a consequence of latent toxoplasmosis infection. This raises the possibility that public health measures to reduce toxoplasmosis infection may also result in a reduction in epilepsy.
对三项病例对照研究进行了荟萃分析,这些研究考察了免疫功能正常宿主中潜伏性弓形虫感染与隐源性癫痫之间的关系。还通过检查17个不同国家、城市或地区的弓形虫病血清阳性率与这些地区的癫痫患病率进行了进一步比较。
荟萃分析结果显示对数比值比为4.8,近似于相似的相对风险(置信区间2.6至7.8),三项研究的置信区间均高于1。弓形虫病血清阳性率与癫痫患病率显示出强烈关联(p<0.001)。
弓形虫病的患病率是癫痫患病率的一个重要因素,在隐源性癫痫中可能存在联系。弓形虫病负担减轻的地区癫痫负担也会减轻。各项研究的神经病理生理学发现表明,弓形虫感染与癫痫中存在小胶质结节形成的共同生理关系。该分析提出,癫痫的众多病因之一可能是一种感染因子,或者隐源性癫痫可能是潜伏性弓形虫感染的结果。这增加了采取公共卫生措施减少弓形虫感染也可能导致癫痫减少的可能性。