Dados do Trabalho

Título

EVALUATING THE ASSOCIATION BETWEEN NEUROCYTICERCOSIS AND TEMPORAL LOBE EPILEPSY WITH HIPPOCAMPAL SCLEROSIS IN A COHORT OF 731 PATIENTS WITH EPILEPSY

Introdução

Neurocysticercosis (NCC) is a form of chronic infection of the CNS. Recently NCC have been associated with hippocampal damage, hippocampal sclerosis (HS) and mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS). However, this association is still not completely established.

Objetivo

To study a cohort of patients with epilepsy evaluating the prevalence of NCC, its characteristics and a possible association between NCC and MTLE-HS.

Método

We review clinical history, electrophysiological data and neuroimaging findings of 731 patients with epilepsy followed in Hospital de Clínicas de Porto Alegre. We studied the prevalence and characteristic of NCC and a possible association of this form of epilepsy with MTLE-HS.

Resultados

From 731 patients, 42 (5.75%) patients had NCC. NCC lesions were more frequent in women than in men (33 female versus 09 male, p=0.001). NCC was observed significantly more often in patients that started epilepsy later in life, in older patients, in patients that had more time of epilepsy and in those patients with less years of school. The combination of tomography and MRI was ideal for detecting chronic calcifications NCC lesions (cNCC) and MTLE-HS in the same patient. MTLE-HS was observed in ninety three (12.7%) of 731 patients. In these, cNCC was present in 25 patients (26.9%). From 638 patients with other types of epilepsy rather than MTLE-HS, cNCC was observed in only 17 (2.7%) of them. In our cohort, NCC was about ten times more frequently associated with MTLE-HS than with other forms of epilepsy, a very significant statistic difference (O.R.=14.29; 95% CI=7.13-33.33; p<0.0001).

Conclusão

As expected, some patients with NCC might have epileptic irritative zone directly related to neurocysticercosis lesions, however this was observed in a surprising lower number of patients. In our study, cNCC lesions were observed in other forms of epilepsy and this could occur only by chance, been epilepsy in these patients probably not related to cNCC. Surprising, in our cohort, NCC was very commonly associated with MTLE-HS, an observation in agreement with the hypothesis that NCC can contribute or directly cause MTLE-HS in many patients. Given the broad world prevalence of NCC and relatively few studies in this field, our study adds more data suggesting a possible and intriguing interplay between NCC and MTLE-HS, two of the most common causes of epilepsy worldwide. Supported by CNPQ and CAPES.