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脑囊虫病作为一种全球性的感染性获得性癫痫。

Neurocysticercosis as an infectious acquired epilepsy worldwide.

机构信息

Department of Neuroscience and Experimental Therapeutics, College of Medicine, Texas A&M University Health Science Center, Bryan, TX 77807, USA.

Department of Neuroscience and Experimental Therapeutics, College of Medicine, Texas A&M University Health Science Center, Bryan, TX 77807, USA.

出版信息

Seizure. 2017 Nov;52:176-181. doi: 10.1016/j.seizure.2017.10.004. Epub 2017 Oct 7.

Abstract

Aside from brain injury and genetic causes, there is emerging information on brain infection and inflammation as a common cause of epilepsy. Neurocysticercosis (NCC), the most common cause of epilepsy worldwide, is caused by brain cysts from the Taenia solium tapeworm. In this article, we provide a critical analysis of current and emerging information on the relationship between NCC infection and epilepsy occurrence. We searched PubMed and other databases for reports on the prevalence of NCC and incidence of epilepsy in certain regions worldwide. NCC is caused by brain cysts from the T. solium and related tapeworms. Many people with NCC infection may develop epilepsy but the rates are highly variable. MRI imaging shows many changes including localization of cysts as well as the host response to treatment. Epilepsy, in a subset of NCC patients, appears to be due to hippocampal sclerosis. Serologic and brain imaging profiles are likely diagnostic biomarkers of NCC infection and are also used to monitor the course of treatments. Limited access to these tools is a key limitation to identify and treat NCC-related epilepsy in places with high prevalence of this parasite infestation. Overall, NCC is a common infection in many patients with epilepsy worldwide. Additional clinical and animal studies could confirm common pathology of NCC as a postinfectious epilepsy that is curable.

摘要

除了脑损伤和遗传原因,越来越多的信息表明脑感染和炎症也是癫痫的常见原因。神经囊尾蚴病(NCC)是世界范围内最常见的癫痫病因,由猪带绦虫的脑囊虫引起。本文对 NCC 感染与癫痫发生之间的现有和新出现的信息进行了批判性分析。我们在 PubMed 和其他数据库中搜索了关于全球某些地区 NCC 流行率和癫痫发病率的报告。NCC 是由猪带绦虫和相关绦虫的脑囊虫引起的。许多患有 NCC 感染的人可能会发展为癫痫,但发病率差异很大。MRI 成像显示出许多变化,包括囊肿的定位以及宿主对治疗的反应。在 NCC 患者的亚组中,癫痫似乎是由于海马硬化引起的。血清学和脑影像学特征可能是 NCC 感染的诊断生物标志物,也用于监测治疗过程。在寄生虫感染高发地区,由于这些工具的获取有限,成为了识别和治疗与 NCC 相关的癫痫的关键限制。总的来说,NCC 在世界范围内许多癫痫患者中是一种常见感染。更多的临床和动物研究可以证实 NCC 作为一种感染后癫痫是可治愈的。

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