Abstracts

Rationale: Hippocampal atrophy often develops in subjects with neurocysticercosis (NCC). It is not known whether atrophy develops as a result of epileptiform activity in these patients, or through an independent mechanism. The goal of the current study is to determine whether hippocampal atrophy in patients with NCC is related to interictal epileptiform or encephalopathic patterns on scalp EEG. Methods: This study is an extension of the Atahualpa project, which follows the residents of the village of Atahualpa, Ecuador, where NCC is endemic. Scalp EEGs were performed in residents who were 40 years or older and who have imaging-confirmed NCC (case-patients) as well as in age- and gender-matched NCC-free individuals (control subjects). Hippocampal atrophy had been previously assessed in these subjects by magnetic resonance imaging, and characterized using the Schelten’s Scale for hippocampal atrophy.  Results: Sixty-two subjects with NCC and 62 matched controls were included in the analysis. Case-subjects had an average of 1.5 NCC lesions (range 1-6, median = 1 lesion). The degree of hippocampal atrophy as assessed by total Schelten’s Scale was significantly greater in case-patients than in control subjects (3.0 ± 1.3 versus 2.4 ± 0.9 points, respectively; p Five of the 62 case-patients had a clinical history of epilepsy, while only one of the control subjects did. Encephalopathic EEG patterns were more prevalent in the five neurocysticercosis subjects with epilepsy (40%) than in those without a history of epilepsy (9%, p Conclusions: That the degree of atrophy in subjects with epilepsy was not different than in subjects without epilepsy suggests that hippocampal atrophy can develop through pathological mechanisms other than seizures or subclinical epileptiform activity in patients with NCC. Funding: Study supported by Universidad Espíritu Santo – Ecuador, Guayaquil, Ecuador. ED, LM and JM were supported by Drs. Martin and Dorothy Spatz Foundation (Sebastopol, CA, USA).