Neurocyticercosis and Mesial Temporal Sclerosis: Does parasite location matters?
Abstract number :
2.433
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2022
Submission ID :
2233037
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:29 AM
Authors :
Iris Martínez-Juárez, MD, MSC, PhD Candidate – National Institute of Neurology and Neurosurgery, Mexico; Andrea M. Peralta-Maza, MD – Research, Epilepsy Clinic /Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery, Mexico; Santiago Philibert -Rosas, MD – Research, Epilepsy Clinic /Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery, Mexico; Karen E. Sánchez-Guzmán, MD – Fellow, Epilepsy Clinic /Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery, Mexico; Mario A. Sebastián-Díaz, MD, MSC, PhD candidate – PhD candidate, Posgraduate Division, Anahuac University; Agnès Fleury, MD, MSC, PhD – Research, Neuroinflamation Department, National Institute of Neurology and Neurosurgery, Mexico
This is a Late Breaking abstract
Rationale: Neurocysticercosis (NCC) is the most common infection of the central nervous system (CNS) in developing countries, with a higher prevalence in women. Seizures due to NCC occur in 70%-90% of cases. In NCC there is an inflammatory infiltrate with presence of cytokines and a blood-brain barrier alteration, depending on the number, size, stage, and location of the NCC, as well as the immune system response. Diagnosis is made by axial tomography (CT) or magnetic resonance imaging (MRI) by visualizing the cyst or larva. Epilepsy secondary to NCC has been associated with mesial temporal sclerosis (MTS), inducing perilesional edema, secondary to epileptic activity, being a predictor of seizure recurrence, acting as a positive feedback. MTS is commonly known as one of the most common drug-resistant focal epilepsies.
Methods: Retrospective study from 2012-2022 at NINNN, 59 patients diagnosed with NCC were reviewed (6 were excluded). A total 27 patients had NCC asociated with MTS.
Results: We found a higher frequency in women in this group of NCC and MTS 19 (70%). Epilepsy due to NCC-MTS occurs at the young age of 12.4+9.2 years. Eighty-five percent (23) of patients had focal seizures and 4 (15%) had focal to bilateral tonic-clonic._x000D_
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With respect to the location, 11 (40.5%) patients had the NCC in the left temporal lobe, 5 (19%) in the right temporal lobe and 11 (40.5%) outside the temporal lobe. _x000D_
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In 21 (78%), the MTS was ipsilateral to the NCC location, and 3 (11%) had the NCC contralateral to the MTS, whereas 3 (11%) had bilateral lesions. _x000D_
Conclusions: Patients with NCC and MTS have an early-onset epilepsy, with focal and focal to bilateral tonic-clonic seizures. In most patients NCC is ipsilateral to the MTS and predominantly in the left hemisphere. Mechanisms of disease and the development of MTS in patients with NCC would help to prevent or treat these patients before they develop epilepsy or the epilepsy becomes drug resistant.
Funding: None
Clinical Epilepsy