Authors :
Presenting Author: Sofía Sanchez Boluarte, MD – Instituto Nacional de Ciencias Neurologicas
Guadalupe Pomasonco - Olivas, BS – Medicine Faculty, Universidad Científica del Sur
Joseph Zunt, PhD – School of Medicine, Universidad de Washington
Javier Bustos - Palomino, MC, MSc, MPH – School of Medicine, Universidad Cayetano Heredia
William Tatum, MD – Mayo Clinic Florida
Héctor García - Lescano, MC, PhD – School of Medicine, Universidad Cayetano Heredia
Rationale:
Relapses of seizures have been described in patients diagnosed with neurocysticercosis who received anticonvulsant and antiparasitic treatments. It should be noted that the frequency of epilepsy in patients with NCC varies by study and region.
Methods: This retrospective cohort study was conducted at a single center, the National Institute of Neurological Sciences of Lima, in patients with viable parenchymal neurocysticercosis who received antiparasitic treatment between 2004 and 2010. The patients were evaluated between November 2023 and August 2024. In this study, we analyzed the frequency and types of seizures, neurological symptoms in patients with neurocysticercosis, and the presence of risk factors such as older age at the onset of seizures, longer duration of epilepsy, neurological examination findings, or psychiatric comorbidities. In this study, the relationships between these variables were evaluated to better understand the clinical manifestations and the evolution of the disease. Uncontrolled epilepsy was defined as the occurrence of a seizure in the previous year due to poor adherence or a lack of access to health services.
Results: A total of 67 adult patients diagnosed with neurocysticercosis presented with epileptic seizures. In the last 5 years, 20 (30.3%) patients presented with seizures and 12 (17.9%) presented with seizures in the previous year. Among the 66 patients with epileptic seizures, 55 (83.3%) presented with focal seizures, with simple focal seizures predominating in 46 (83.6%) patients. Motor-onset seizures were observed in 21 (45.7%) patients, sensory-onset seizures in 24 (52.2%), sensory seizures in 26 (56.5%), and psychic seizures in 2 (4.3%). . Focal seizures with altered consciousness occurred in 12 (22.2%) patients, of which six (54.5%) presented automatisms. Furthermore, of 28/55 (50.9%) patients progressed to bilateral or generalized tonic-clonic seizures. Status epilepticus occurred in seven (10.6%) patients, of which six (85.7%) had convulsions. Regarding other symptoms, 56 (83.6%) patients experienced headaches unrelated to epileptic seizures, 40 (62.5%) experienced cognitive impairment, 37 (57.8%) experienced sleep disorders, 31 (48.5%) .4%) experienced psychiatric symptoms, and 28 (43.8%) experienced dizziness. Furthermore, 49 (73.1%) patients had a history of pathological conditions, particularly alcohol consumption in 25 (25.5%) and smoking in 6 (12.2%) patients.
Conclusions: In the last year, 18.2% of the individuals with a history of neurocysticercosis experienced seizure relapse. The results showed that neurocysticercosis is associated with a high frequency of neurological symptoms such as headaches, cognitive impairment, and sleep disorders. In addition, a significant number of patients had a history of alcohol consumption and smoking.
Funding: Funded by the Fogarty- NIH - North Pacific Global Health Leadership, Education and Development program for early career researchers (NPGH) and NINDS, and
D43 TW001140.