Winkler Andrea Sylvia, Blocher Joachim, Auer Herbert, Gotwald Thaddaeus, Matuja William, Schmutzhard Erich
Department of Neurology, Ludwig-Maximilians-University, Munich, Germany.
Epilepsia. 2009 May;50(5):987-93. doi: 10.1111/j.1528-1167.2008.01867.x. Epub 2008 Nov 19.
In developing countries, neurocysticercosis (NCC) is a common cause of epilepsy. Most of the work on NCC and epilepsy has been compiled in Latin America. To date, comprehensive neuroimaging studies are missing in sub-Saharan Africa.
In our study, we interviewed 212 people with epilepsy (PWE) and performed cerebral computed tomography (CT) at the Haydom Lutheran Hospital in northern Tanzania. Control cerebral CT scans were selected from 198 consecutive individuals without epilepsy. Sera of PWE with lesions indicating NCC (n = 20), PWE without NCC lesions (n = 20), and healthy individuals (n = 20), as well as cerebrospinal fluid (CSF) samples of PWE with NCC lesions (n = 11) were investigated for anticysticercal antibodies.
Definite NCC lesions were present in five (2.4%), lesions highly suggestive of NCC in 24 (11.3%), and lesions compatible with NCC in nine (4.2%) PWE. This compares to two (1.0%) people with definite NCC lesions, two (1.0%) with lesions highly suggestive of, and six (2.9%) with lesions compatible with NCC in the control group. NCC lesions were significantly more frequent in PWE compared to controls (p < 0.0001). CT results, and serum and CSF analysis taken together, we diagnosed 22 (10.4%) individuals with probable and 7 (3.3%) with definitive NCC in our cohort of PWE.
For the first time in sub-Saharan Africa, we give evidence within a large-scale neuroimaging study that NCC, a so far neglected infectious disease, represents a major cause of epilepsy.
在发展中国家，神经囊尾蚴病（NCC）是癫痫的常见病因。大多数关于NCC与癫痫的研究成果都来自拉丁美洲。迄今为止，撒哈拉以南非洲地区仍缺乏全面的神经影像学研究。
在我们的研究中，我们对212例癫痫患者（PWE）进行了访谈，并在坦桑尼亚北部的海多姆路德医院为他们进行了脑部计算机断层扫描（CT）。对照脑部CT扫描则选取了198名无癫痫病史的连续个体。对有NCC病变迹象的PWE患者（n = 20）、无NCC病变的PWE患者（n = 20）和健康个体（n = 20）的血清，以及有NCC病变的PWE患者（n = 11）的脑脊液（CSF）样本进行了抗囊尾蚴抗体检测。
5例（2.4%）PWE患者存在明确的NCC病变，24例（11.3%）有高度疑似NCC的病变，9例（4.2%）有与NCC相符的病变。相比之下，对照组中有2例（1.0%）存在明确的NCC病变，2例（1.0%）有高度疑似病变，6例（2.9%）有与NCC相符的病变。与对照组相比，PWE患者中的NCC病变明显更为常见（p < 0.0001）。综合CT结果、血清和脑脊液分析，在我们的PWE队列中，我们诊断出22例（10.4%）可能患有NCC，7例（3.3%）确诊患有NCC。
在撒哈拉以南非洲地区，我们首次在一项大规模神经影像学研究中证明，NCC作为一种迄今被忽视的传染病，是癫痫的主要病因。
