Neurocysticercosis – A Journey from Pre-independence to Modern India

ABSTRACT

Neurocysticercosis (NCC) is infestation of the human brain by the larva of worm, Taenia solium and is the most prevalent central nervous system (CNS) helminthiasis. The disease is widespread in tropical and subtropical regions of the world, including the Indian subcontinent, China, Sub-Saharan Africa, Central and South America and contributes substantially to the burden of epilepsy in these areas(1) . CNS involvement is seen in 60-90% of systemic cysticercosis. About 2.5 million people worldwide are infected with T. solium, and antibodies to T. solium are seen in up to 25% of people in endemic areas(1-3) . A higher prevalence of epilepsy and seizures in endemic countries is partly because of a high prevalence of cysticercosis in these regions. Seizures are thought to be caused by NCC in as many as 30% of adult patients and in 51% of children in population based endemic regions (2) . About 12% of admissions to neurological services in endemic regions are attributed to NCC and nearly half a million deaths occurring annually worldwide can be attributed directly or indirectly to NCC (Bern et al.). Punctate calcific foci on CT scan are a very common finding in asymptomatic people residing in endemic areas, found in 14-20 % of CT scans. Both seizures and positive cysticercus serology are associated with the detection of cysticerci on CT scans. Seroprevalence using a recently developed CDC- based enzyme-linked immunotransfer blot (EITB) assay is estimated at 8-12% in Latin America and 4.9-24% in Africa and South-East Asia. It is estimated that 20 million people harbour neurocysticercosis worldwide(1) .

Keywords

Neurocysticercosis(NCC) - SCG - T. Solium - cysticerci

DR. BALDEV SINGH ORATION delivered during NAMSCON 2015 at the All-India Institute of Medical Sciences, Patna.

Publikationsverlauf

Artikel online veröffentlicht:
09. Mai 2020

• REFERENCES

• 1 Bern C, Garcia HH, Evans C, et al. (1999). Magnitude of the disease burden from neurocysticercosis in a developing country. Clin Infect Dis 29(5):1203-1209.
• 2 Montano S M , Villaran M V, Ylquimiche L, et al. (2005). Neurocysticercosis: association between seizures, serology, and brain CT in rural Peru. Neurology 65(2):229-233.
• 3 Del Brutto OH, Santibanez R, Noboa CA, Aguirre R, Diaz E, Alarcon TA (1992). Epilepsy due to neurocysticercosis: analysis of 203 patients. Neurology 42(2):389-392.
• 4 Medina MT, Rosas E, Rubio- Donnadieu F, Sotelo J (1990). Neurocysticercosis as the main cause of late-onset epilepsy in Mexico . Arch Intern Med 150(2):325-327.
• 5 Garcia HH, Del Brutto OH, Cysticercosis Working Group in Peru (2005). Neurocysticercosis: updated concepts about an old disease. Lancet Neurol 4(10):653- 661.
• 6 Escobar A, Aruffo C, Cruz-Sanchez F, Cervos-Navarro J (1985). Neuropathologic findings in neurocysticercosis. Arch Neurobiol (Madr.) 48(3):151-156.
• 7 Carpio A, Placencia M, Santillan F, Escobar A (1994). A proposal for classification of neurocysticercosis. Canadian J Neurologi Sci 21(1):43- 47.
• 8 Garcia HH, Del Brutto OH (1999). Heavy nonencephalitic cerebral cysticercosis in tapeworm carriers. The Cysticercosis Working Group in Peru. Neurology 53(7):1582- 1584.
• 9 Wadia N, Desai S, Bhatt M (1988). Disseminated cysticercosis. New observations, including CT scan findings and experience with treatment by praziquantel. Brain 111 (Pt 3):597-614.
• 10 Rajashekhar V (2003). Solitary cerebral cysticercus granuloma. Epilepsia 44 Suppl 1: 25-28.
• 11 McCormick GF, Zee CS, Heiden J (1982). Cysticercosis cerebri. Review of 127 cases. Arch Neurol 39(9):534-539.
• 12 Grisolia JS, Wiederholt WC (1982). CNS cysticercosis. Arch Neurol 39(9):540-544.
• 13 Garcia HH, Gilman RH, Gonzalez AE, Pacheco R, Verastegui M, Tsang VC (1999). Human and porcine Taenia solium infection in a village in the highlands of Cusco, Peru. The Cysticercosis Working Group in Peru. Acta Trop 73(1):31- 36.
• 14 Garcia HH, Gonzalez AE, Del Brutto OH, et al. (2007). Strategies for the elimination of taeniasis/ cysticercosis. J Neurol Sci 262(1- 2):153-157.
• 15 Murthy JM, Rajshekar G (2007). Economic evaluation of seizures associated with solitary cysticercus granuloma. Neurology India 55(1):42-45.
• 16 Pawlowski Z, Allan J, Sarti E (2005). Control of Taenia solium taeniasis/cysticercosis: from research towards implementation. Int J Parasitol 35(11-12):1221- 1232.
• 17 Schantz PM (2006). Progress in diagnosis , treatment and elimination of echinococcosis and cysticercosis. Parasitol Intl 55 Suppl:S7-S13.
• 18 Garcia HH, Del Brutto OH (2000). Taenia solium cysticercosis. Infect Dis Clin North Am 14(1):97-119, ix.
• 19 Garcia HH, Del Brutto OH, Nash TE, White AC Jr, Tsang VC, Gilman RH (2005). New concepts in the diagnosis and management of neurocysticercosis (Taenia solium). Am J Trop Med Hyg 72(1):3-9.
• 20 Carpio A ( 2002 ) . Neuro - cysticercosis: an update. Lancet Infect Dis 2(12):751-762.
• 21 Cambier PA, Kirby WC, Wortham DC, et al. (1992). Percutaneous closure of the small (less than 2.5 mm) patent ductus arteriosus using coil Embolization. Am J Cardiol 69: 815 – 816.Rajshekhar V, Raghava MV, Prabhakaran V, Oommen A, Muliyil J (2006). Active epilepsy as an i n d e x o f b u r d e n o f n e u r o - cysticercosis in Vellore district, India. Neurology 67(12):2135- 2139.
• 22 Sotelo J, Guerrero V, Rubio F (1985). Neurocysticercosis: a new classification based on active and inactive forms. A study of 753 cases. Arch Intern Med 145(3):442- 445.
• 23 Wiederholt WC, Grisolia JS (1982). Cysticercosis : An old scourge revisited. Arch Neurol 39(9):533.
• 24 Mitchell WG (1997). Pediatric neurocysticercosis in North America. Eur Neurol 37(2):126- 129.
• 25 Mitchell WG, Crawford TO (1988). Intraparenchymalcerebral cysticercosis in children: diagnosis and treatment. Pediatrics 82(1):76- 82.
• 26 Singh G, Singh P, Singh I, Rani A, Kaushal S, Avasthi G (2006). Epidemiologic classification of seizures associated with neurocysticercosis: observation from a sample of seizure disorders in neurologic care in India. Acta Neurol Scand 113(4):233-240.
• 27 Tsang VC, Brand JA, Boyer AE (1989) . Anenzyme - linked immunoelectrotransfer blot assay and glycoprotein antigens for diagnosing human cysticercosis (Taenia solium). J Infect Dis 159(1):50-59.
• 28 Singh G, Kaushal V, Ram S, Kaushal RK , Dhanuka AK , Khurana S (1999). Cysticercus immunoblot assay in patients with single, small enhancing lesions and multilesional neurocysticercosis. J Assoc Physicians India 47(5):476- 479.
• 29 Ahuja GK, Behari M, Prasad K, Goulatia RK, Jailkhani BL (1989). Disappearing CT lesions in epilepsy : Is tuberclosis or cysticercosis the cause ? J Neurol Neurosurg Psychiatry 52(7) : 915- 916.
• 30 Garg RK (2002). Single enhancing computerized tomography detected lesion in immunocompetent patients . Neurosurg Focus 12(6):e4.
• 31 Murthy JM, Yangala R (1998). E t i o l o g i c a l s p e c t r u m o f symptomatic localization related epilepsies: A study from South India. J Neurol Sc 158(1):65-70.
• 32 Garg RK, Agrawal A, Verma M (1991). CT spectrum of neurocysticercosis. J Assoc Physicians India 39(9):726-727.
• 33 Del Brutto OH (1995). Single parenchymal brain cysticercus in the acute encephalitic phase: definition of a distinct form of neurocysticercosis with a benign prognosis. J Neurol Neurosurg Psychiatry 58(2):247-249.
• 34 Bhargava S, Tandon PN (1980). Intracranial tuberculomas: a CT study. Brit J Radiol 53(634):935- 945.
• 35 Wadia RS, Makhale CN, Kelkar AV, Grant KB (1987). Focal epilepsy in India with special reference to lesions showing ring or disc-like enhancement on contrast computed tomography. J Neurol Neurosurg Psychiatry 50(10):1298-1301..
• 36 Sethi PK, Kumar BR, Madan VS, Mohan V (1985). Appearing and disappearing CT scan abnormalities and seizures. J Neurol Neurosurg Psychiatry 48(9):866-869.
• 37 Chopra JS, Sawhney IM, Suresh N, Prabhakar S, Dhand UK, Suri S (1992). Vanishing CT lesions in epilepsy. J Neurol Sci 107(1):40-49.
• 38 Chandy MJ, Rajshekhar V, Prakash S, et al. (1989). Cysticercosis causing single, small CT lesions in Indian patients with seizures. Lancet 1(8634):390-391.
• 39 Rajshekhar V, Chacko G, Haran RP, Chandy MJ, Chandi SM (1995). C l i n i c o r a d i o l o g i c a l a n d pathological correlations in patients with solitary cysticercus granuloma and epilepsy: focus on presence of the parasite and oedema formation. J Neurol Neurosurg Psychiatry 59(3):284-286.
• 40 Rajshekhar V, Chandy MJ (1996). Comparative study of CT and MRI in patients with seizures and a solitary cerebral cysticercus granuloma. Neuroradiology 38(6): 542-546.
• 41 Rajshekhar V (1991). Etiology and management of single small CT lesions in patients with seizures: understanding a controversy. Acta Neurol Scand 84(6):465-470.
• 42 Rajshekhar V, Chandy MJ (1997). Validation of diagnostic criteria for solitary cerebral cysticercus granuloma in patients presenting with seizures. Acta Neurol Scand 96(2):76-81.
• 43 Singh G, Rajshekhar V, Murthy JM, et al. (2010). A diagnostic and therapeutic scheme for a solitary cysticercus granuloma. Neurology 75(24):2236-2245.
• 44 Robles C (1982). Mortality in 100 patients with neurocysticercosis treated with praziquantel. Salud publica a Mex 24(6):629-632.
• 45 Robles C, Sedano AM, Vargas- Tentori N, Galindo-Virgen S (1987). Long-term results of praziquantel therapy in neurocysticercosis. J Neurosurgery 66(3):359-363.
• 46 Robles C, Sedano AM, Vargas- Tentori N, Galindo-Virgen S (1987). Long-term results of praziquantel therapy in neurocysticercosis. J Neurosurgery 66(3):359-363.
• 47 Sotelo J, Escobedo F, Penagos P (1988) . Albendazole vs praziquantel for therapy for neurocysticercosis. A controlled trial. Arch Neurol 45(5):532-534.
• 48 Sotelo J, Penagos P, Escobedo F, Del Brutto OH (1988). Short course o f a l b e n d a z o l e t h e r a p y f o r neurocysticercosis. Arch Neurol 45(10):1130-1133.
• 49 Sotelo J, Penagos P, Escobedo F, Del Brutto OH (1988). Short course o f a l b e n d a z o l e t h e r a p y f o r neurocysticercosis. Arch Neurol 45(10):1130-1133.
• 50 Garcia HH, Gonzalez AE, Evans CA, Gilman RH, Cysticercosis Working Group in Peru (2003). Taenia solium cysticercosis. Lancet 362(9383):547-556.
• 51 Garcia HH, Pretell EJ, Gilman RH, et al. (2004). A trial of antiparasitic treatment to reduce the rate of s e i z u r e s d u e t o c e r e b r a l cysticercosis. NEJM 350(3):249- 258.
• 52 Otte WM, Singla M, Sander JW, Singh G (2013). Drug therapy for Solitary Cysticercus Granuloma. Neurology 80: 152-162.
• 53 Singh G, White AC Jr. (2014). Determining better treatments for neurocysticercosis. Lancet Infect Dis 14: 658-659.
• 54 Nash TE, Singh G, White AC, et al. (2006). Treatment of neurocysticercosis: current status and future research needs. Neurology 67(7):1120-1127.
• 55 Singh G, Kaushal S, Gupta M, C h a n d e r C h o p r a S ( 2 0 0 4 ) . Cutaneous reactions in patients with solitary cysticercus granuloma on phenytoin sodium. J Neurol Neurosurg Psychiatry 75(2):331- 333.
• 56 Alarcon F (2001). Short course of albendazole therapy for neurocysticercosis: a prospective randomized trial comparing three days, eight days, and a control group without albendazole. Rev Ecuat Neurol 10:1-2.
• 57 B a r a n w a l A K , S i n g h i P D , Khandelwal N, Singhi SC (1998). Albendazole therapy in children with focal seizures and single small enhancing computerized tomographic lesions: a randomized, placebo-controlled, double blind trial. Pediatr Infect Dis J 17(8):696- 700.
• 58 Chaurasia RN, Garg RK, Agarwall A, et al. (2010). Three day albendazole therapy in patients with a solitary cysticercus granuloma: a randomized double blind placebo controlled study. Southeast Asian J Trop Med Public Health 41(3):517- 525.
• 59 de Souza A, Nalini A, Kovoor JM, Yeshraj G, Siddalingaiah HS, Thennarasu K (2011). Perilesional gliosis around solitary cerebral parenchymal cysticerci and longterm seizure outcome: a prospective study using serial magnetization transfer imaging. Epilepsia 52(10) :1918-1927.
• 60 Gogia S, Talukdar B, Choudhury V, Arora BS (2003) . Neur o - cysticercosis in children: clinical findings and response to albendazole therapy in arandomized , double - blind , placebo-controlled trial in newly diagnosed cases. Trans R Soc Trop Med Hyg 97(4):416-421.
• 61 Kalra V, Dua T, Kumar V (2003). Efficacy of albendazole and shortcourse dexamethasone treatment in children with 1 or 2 ring-enhancing lesions of neurocysticercosis: a randomized controlled trial. J Pediatr 143(1):111-114.
• 62 Padma MV, Behari M, Misra NK, Ahuja GK (1994). Albendazole in single CT ring lesions in epilepsy. Neurology 44(7):1344-1346.
• 63 Pretell EJ, Garcia HH, Custodio N, et al. (2000). Short regimen of praziquantel in the treatment of single brain enhancing lesions. Clin Neurol Neurosurg 102(4):215-218.
• 64 Singhi P, Jain V, Khandelwal N (2004). Corticosteroids versus albendazole for treatment of single small enhancing computed tomographic lesions in children with neurocysticercosis. J Child Neurol 19(5):323-327.
• 65 Thussu A, Chattopadhyay A, Sawhney IM, Khandelwal N (2008). Albendazole therapy for single small enhancing CT lesions (SSECTL) in the brain in epilepsy. J Neurol Neurosurg Psychiatry 79(3):272-275.
• 66 Garg RK, Potluri N, Kar AM, et al. ( 2 0 0 6 ) . S h o r t c o u r s e o f prednisolone in patients with solitary cysticercus granuloma: a double blind placebo controlled study. J Infect 53(1):65-69.
• 67 Kishore D, Misra S (2007). Short course of oral prednisolone on disappearance of lesion and seizure recurrence in patients of solitary cysticercal granuloma with single small enhancing CT lesion: an open label randomized prospective study. JAPI 55:419–424.
• 68 Mall RK, Agarwal A, Garg RK, Kar AM, Shukla R (2003). Short course of prednisolone in Indian patients with solitary cysticercus granuloma and new-onset seizures. Epilepsia 44(11):1397-1401.
• 69 Prakash S, Garg RK, Kar AM, et al. (2006) . Intravenousmethy l prednisolone in patients with solitary cysticercus granuloma: arandom evaluation. Seizure 15(5):328-332.
• 70 Singla M, Prabhakar S, Modi M, Medhi B, Khandelwal N, Lal V (2011) . Short - course of prednisolone in solitary cysticercus granuloma: A randomized, doubleblind, placebo-controlled trial. Epilepsia 52(10): 1914-1917.
• 71 Thussu A, Arora A, Prabhakar S, Lal V, Sawhney IM (2002). Acute symptomatic seizures due to single CT lesions: how long to treat with antiepileptic drugs? Neurology India 50(2):141-144.
• 72 Gupta M, Agarwal P, Khwaja GA, et al. (2002). Randomized prospective study of outcome of short term antiepileptic treatment in small single enhancing CT lesion in brain. Neurology India 50(2):145-147.
• 73 Verma A, Misra S (2006). Outcome of short - term antiepileptic treatment in patients with solitary cerebral cysticercus granuloma. Acta Neurol Scand 113(3):174-177.
• 74 Rajshekhar V, Jeyaseelan L (2004). Seizure outcome in patients with a solitary cerebral cysticercus granuloma. Neurology 62(12): 2236-2240.
• 75 Nash TE, Del Brutto OH, Butman JA, et al. (2004). Calcific neurocysticercosis and epileptogenesis. Neurology 62(11):1934-1938.
• 76 Pradhan S, Kathuria MK, Gupta RK (2000). Perilesional gliosis and seizure outcome: a study based on magnetization transfer magnetic resonance imaging in patients with neurocysticercosis. Ann Neurol 48(2):181-187.
• 77 Kaushal S, Rani A, Chopra SC, Singh G (2006). Safety and efficacy of clobazam versus phenytoinsodium in the antiepileptic drug treatment of solitary cysticercus granulomas. Neurology India 54(2):157-160.