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Neurocysticercosos in South-Central America and the Indian Subcontinent: a comparative evaluation

Abstract

Neurocysticercosis is an important public health problem in South-Central America and South Asia. A review of the differences in epidemiological and clinical attributes of cysticercosis and taeniasis in South Central America and India, respectively, is undertaken in the present communication. Intestinal taeniasis is hyperendemic in several American countries. In comparison, the prevalence of Taenia solium infestation is lower in India. The clinical manifestations in several American neurocysticercosis series comprise epilepsy, intracranial hypertension and meningeal - racemose cysticercosis, in roughly equal proportions. An overwhelming majority of the Indian subjects present with seizures. The commonest pathological substrate of the disorder in Indian patients is the solitary parenchymal degenerating cyst. The reasons for the predominance of solitary forms in India, and of multilesional forms in South Central America are discussed. The magnitude of Taenia solium infestation and the frequency of pork consumption in a given population appear to influence the quantum of cyst load in affected individuals.

neurocysticercosis; taeniasis; epidemiology; clinical features; transmission


Neurocysticercosos in South-Central America and the Indian Subcontinent. A comparative evaluation

Gagandeep Singh

Division of Neurology Dayanand Medical College, (Ludhiana - 141 001 Punjab) India

ABSTRACT

Neurocysticercosis is an important public health problem in South-Central America and South Asia. A review of the differences in epidemiological and clinical attributes of cysticercosis and taeniasis in South Central America and India, respectively, is undertaken in the present communication. Intestinal taeniasis is hyperendemic in several American countries. In comparison, the prevalence of Taenia solium infestation is lower in India. The clinical manifestations in several American neurocysticercosis series comprise epilepsy, intracranial hypertension and meningeal - racemose cysticercosis, in roughly equal proportions. An overwhelming majority of the Indian subjects present with seizures. The commonest pathological substrate of the disorder in Indian patients is the solitary parenchymal degenerating cyst. The reasons for the predominance of solitary forms in India, and of multilesional forms in South Central America are discussed. The magnitude of Taenia solium infestation and the frequency of pork consumption in a given population appear to influence the quantum of cyst load in affected individuals.

Key words: neurocysticercosis, taeniasis, epidemiology, clinical features, transmission.

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Aceite: 26-março-1997.

Gagandeep Singh, MD, DM - B-456, Randhir Singh Nagar - Ludhiana 141 001, Punjab - India.

  • 1. Acha PN, Aquilar FJ. Studies on cysticercosis in Central America and Panama. Am J Trop Med Hyg 1964;13:48-53.
  • 2. Agapeje 'S, Meira DA, Barravierra B, Machado JM, Marques PC, Mendes RP, Kamegasawa A, Ueda AK. Neurocysticercosis: treatment with albendazole and dextrochloropheniramine. Trans R Soc Trop Med Hyg 1989;83:377-383.
  • 3. Ahuja GK, Behari M, Prasad K, Goulatia RK, Jailkhani BL. Disappearing CT lesions in epilepsy: is tuberculosis or cysticercosis the cause? J Neurol Neurosurg Psychiatry 1989;52:915-916.
  • 4. Arruda WO, Camargo NJ, Coelho RC. Neurocysticercosis: an epidemiological survey in two small rural communities. Arq Neuropsiquiatr 1990;48:419-424.
  • 5. Bickerstaff ER, Cloake PCP, Hughes B. The racemose form of cerebral cysticercosis. Brain 1952;75:1-18.
  • 6. Briceno F, Biagi F. Martinez B. Cisticercosis: observaciones sobre 97 casos de autópsia. Prens Med Mex 1961;26:193-197.
  • 7. Chandy MJ, Rajshekhar V, Prakash S, Ghosh S, Joseph T, Abraham J, Chandi SM. Cysticercosis causing single small CT lesions in Indian patients with seizures. Lancet 1989;(i):390-391.
  • 8. Chandy MJ, Rajshekhar V, Ghosh S, Prakash S, Joseph T, Abraham J, Chandi SM. Single small enhancing CT lesions in Indian patients with epilepsy: clinical, radiological and pathological considerations. J Neurol Neurosurg Psychiatry 1991;54:702-705.
  • 9. Chequer RS, Vieira VL. Neurocysticercosis in the state of Espirito Santo, Brazil: evaluation of 45 cases. Arq Neuropsiquiatr 1990;48:431-440.
  • 10. Chopra JS, Sawhney IMS, Suresh N, Prabhakar S, Dhand UK, Suri S. Vanishing CT lesions in epilepsy. J Neurol Sci 1992;107:40-49.
  • 11. Das SK, Nityanand S, Sood K, Agarwal A, Kapoor R, Pant MC, Singh BN. Japanese B encephalitis with neurocysticercosis. J Assoc Physic Ind 1991;39:643-644.
  • 12. Dhamija RM, Venkataraman S, Sanchetee PC, Roy AK, Bhatia HC. Computed tomographic spectrum of neurocysticercosis. J Assoc Physic Ind 1990;38:566-568.
  • 13. Diaz F, Garcia HH, Gilman R et al. Epidemiology of taeniasis and cysticercosis in a Peruvian village. Am J Epidemiol 1992;135:875-882.
  • 14. Dixon HBF, Lipscomb FM. Cysticercosis: an analysis and follow up of 450 cases. Medical Research Council Special Report. Series no. 299. London. Her Majesty's Stationery Office, 1961:1 -58.
  • 15. Farahmanidan 1, Sabba GH, Arfaa F, Movagezh K. A comparison of stool examination and mass treatment for indications of prevalence of Taenia saginata. Trop Geogr Med 1973;171:25-27.
  • 16. Flisser A, Plancarte A, Corrêa D, Rodriguez DRE, Feldman M, Sandoval M, Torres A, Meza A, Parkhouse RM, Harrison LJ. New approaches in the diagnosis of Taenia solium cysticercosis and taeniasis. Ann Parasito! Hum Comp 1990;65 (Suppl) 95-98.
  • 17. Flisser A, Sarti E, Bronfman M, Schantz R Intervention strategies for the control of human cysticercosis (Abstr). Proceedings 2nd International Congress of Tropical Neurology. Limoges, 1994:46.
  • 18. Flisser A, Woodhouse E, Larralde C. Epidemiology of human cysticercosis in Mexico. In Palácios E, Rodriguez-Carbajal J, Taveras J (eds.). Cysticercosis of the central nervous system. Springfield: Charles C Thomas, 1983:7-17.
  • 19. Garcia HH, Martinez M, Gilman R, Herrera G, Tsang VCW, Pilcher JB, Diaz F, Verastegui M, Gallo C, Porras M, Alvarado M, Naranjo J, Miranda E. Diagnosis of cysticercosis in endemic regions. Lancet 1991;338:549-551.
  • 20. Gelfand M, Jefferey C. Cerebral cysticercosis in Rhodesia. J Trop Med Hyg 1973;76:87-89.
  • 21. Grisolia JS, Wiederholt WC. CNS cysticercosis. Arch Neurol 1982;39:540-544.
  • 22. Kalra V, Sethi A. Childhood neurocysticercosis: epidemiology diagnosis and course. Acta Paediatr Jpn 1992;34:365-370.
  • 23. Kramer LD, Locke GE, Byrd SE, Daryabagi J. Cerebral cysticercosis: documentation of natural history with CT. Radiology 1989;171:459-462.
  • 24. Loo L Braude A. Cerebral cysticercosis in San Diego: a report of 23 cases and a revision of literature. Medicine, 1982:61:341 -359.
  • 25. Mahajan RC. Geographical distribution of human cysticercosis. In Flisser A, Willms K, Laclette JP, Larralde C, Ridaura C, Beltran F (eds). Cysticercosis: present state of knowledge and perspectives. New York: Academic Press, 1982:39-46.
  • 26. Mahajan RC, Chopra JS. Chitkara NL. Comparative evaluation of indirect haemagglutination and complement fixation tests in serodiagnosis of cysticercosis. Indian J Med Res 1975;63:121-125.
  • 27. Mahajan RC, Malla N. Parasitic infections of the central nervous system. In Abraham J (ed). Progress in clinical neurosciences. Vol 8. Madras Gaurdian Press, 1992:82-91.
  • 28. McCormick GF, Zee CS, Heiden J. Cysticercosis cerebri: review of 127 cases. Arch Neurol 1982;39:534-539.
  • 29. Miller B, Grinnell V, Goldberg MA, Heiner D. Spontaneous radiographic disappearance of cerebral cysticercosis: three cases. Neurology 1983;33:1377-1379.
  • 30. Mitchell WG, Crawford TO. Intraparenchymal cerebral cysticercosis in children: diagnosis and treatment. Pediatrics 1988;82:76-82.
  • 31. Murthy JMK, Ravi Y. The syndromic classification of the international League against Epilepsy: a hospital based study from South India. In Chopra JS, Sawhney IMS (eds). Progress in Neurology. New Delhi: Bl Churchill Livingstone, 1995:53-67.
  • 32. Nussenzweig RS. Parasitic disease as a cause of immunosupression. N Engl J Med 1982;306:423-424.
  • 33. Olive JI, Angulo R Cysticercosis of the nervous system. 1. Introduction and general aspects. J Neurosurg 1962;19:632-634.
  • 34. Rajshekhar V. Etiology and management of single small CT lesions in patients with seizures: understanding a controversy. Acta Neurol Scand, 1991;84:465-470.
  • 35. Rajshekhar V, Haran RP, Prakash GS, Chandy MJ. Differentiating solitary small cysticercus granulomas and tuberculomas in patients with epilepsy: clinical and computerized tomographic criteria. J Neurosurg 1993;78:402-407.
  • 36. Rajshekhar V, Wilson M,. Schantz PM. Cysticercus immunoblot assay in Indian patients with single small enhancing CT lesions. J Neurol Neurosurg Psychiatry 1991 ;54:561.
  • 37. Rangel R, Torres B, Del Bruto 0, Sotelo J. Cysticercotic encephalitis: a severe form in young females. Am J Trop Med Hyg 1987;36:387-392.
  • 38. Richards FO Jr, Schantz PM, Ruiz-Tiben E, Sorvillo FJ. Cysticercosis in Los Angeles county. JAMA 1985;254:3444-3448.
  • 39. Sarti E, Schantz PM, Plancarte A, Wilson M, Gutierrez OI, Aguilera J, Roberts J, Flisser A. Epidemiological investigation of Taenia solium taeniasis and cysticercosis in a rural village of Michoacan State, Mexico. Trans R Soc Trop Med Hyg 1994;88:49-52.
  • 40. Sawhney IMS, Lekhra OP, Chopra JS. Evaluation of epilepsy management and future guidelines for a developing country. In Chopra JS, Sawhney IMS (eds). Progress in Neurology. New Delhi: Bl Churchill Livingstone, 1995:28-37.
  • 41. Schantz PM. Surveillance and control for cestode diseases. In Miller MJ, Love EJ (eds). Parasitic diseases: treatment and control. Florida: CRC Press, 1989:275-290.
  • 42. Schantz PM, Sarti E, PlancarteA, Wilson M, Criales JL, Roberts J, Flisser A. Community based epidemiological investigations of cysticercosis due to Taenia solium: comparison of serologic screening tests and clinical findings in two populations in Mexico. Clin Infect Dis 1994:18;879-885.
  • 43. Schenone H, Vlllarroel F, Rojas A, Ramirez R. Epidemiology of human cysticercosis in Latin America. In Flisser A, Willms K, Laclette JP, Larralde C, Ridaura C, Bel Iran F (eds). Cysticercosis: present state of knowledge and perspectives. New York: Academic Press, 1982:25-28.
  • 44. Shankar SK, Rao TV, Mmthyunjayana BP, Devi MG, Deshpande DH. Autopsy study of brain damage during an epidemic of Japanese encephalitis in Karnataka. Indian J Med Res 1983;78:431-440.
  • 45. Silva-Vergara ML, Vieira CO, Castro JH, Micheletti LG'Otano AS, Franquini JJ, Cabral M, Leboreiro A, Marques JO, de Souza WF. Neurologic and laboratory findings in a population of an endemic area for taeniasis-cysticercosis, Lagamar, MG, Brazil (1992 -1993). Rev Inst Med Trop Sao Paulo 1994,36:335-342.
  • 46. Singhal BS, Ladiwala U. Epidemiology of neurocysticercosis in Asia (Abstr). In Proceedings 2nd International Congress of Tropical Neurology. Limoges, 1994:36.
  • 47. Sotelo J, Guerrero V, Rubio F. Neurocysticercosis: a new classification based on active and inactive forms: a study of 753 cases. Arch Intern Med 1985;145:442-445.
  • 48. Spina-França A, Nobrega JPS, Livramento JA, Machado LR. Administration of praziquantel in neurocysticercosis. Trop Med Parasitol 1982;36:1-14.
  • 49. Stern WE. Neurosurgical considerations of cysticercosis of the central nervous system. J Neurosurg 1981;55:382-389.
  • 50. Thussu A, Shah P, Prabhakar S, Chopra JS, Sharma M, Sehgal S. Immunological profile: single small enhancing CT lesions vs neurocysticercosis (Abstr). Neurology India, 1994;42(Suppl):35.
  • 51. Tsang VCW, Brand J, Boyer E. Enzyme linked immunoelectrotransfer blot assay and glycoprotein antigens for diagnosing human cysticercosis (Taenia solium). J Infect Dis 1989;159:50-59.
  • 52. Venkataraman S. Neurocysticercosis: concepts and controversies. In Mehta PJ (ed). Medicine update. New Delhi: Passi Publications, 1995:799-808.
  • 53. Venkataraman S, Roy AK, Dhamija RM, Sanchetee PC. Cysticercal meningoencephalitis: clinical presentation and autopsy findings. J Assoc Physic Ind 1990;38:763-765.
  • 54. Wadia N, Desai S, Bhatt M. Disseminated cysticercosis: new observations, including CT scan findings and experience with treatment with praziquantel. Brain 1988;] 11:597-614.
  • 55. Wadia RS, Makhale CN, Kelkar AV, Grant KB. Focal epilepsy in India with special reference to lesions showing ring or disc like enhancement on contrast computed tomography. Neurol Neurosurg Psychiatry 1987;50:1298-1301.
  • 56. Wiederholt WC, Grisolia JS. Cysticercosis: an old scourge revisited. Arch Neurol 1982;39:533.

Publication Dates

  • Publication in this collection
    18 Oct 2010
  • Date of issue
    Sept 1997
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