Epilepsy and neurocysticercosis in an Andean community.
Résumé
T. solium neurocysticercosis (NCC) has been documented as one of the major causes for epilepsy in developing countries. We applied the WHO protocol for epidemiological evaluation of neurological disorders in a door-to-door survey among 2,723 residents of an Ecuadorean rural community, known to be endemic for T. solium taeniosis/cysticercosis. We complemented the use of this protocol by neuroimaging and immunological tests to confirm the diagnosis of this infection. Thirty-one individuals suffering from active epilepsy were detected (prevalence ratio 11.4 per thousand, CI 7.7–15.4). Twenty-six of these patients agreed to have a computed tomography (CT) examination, and 28 accepted to have their blood drawn for electron immunotransfer blot (EITB) testing. Fourteen of the 26 (53.8%) and 6 of the 28 (21.4%) patients were positive for cysticercal infection. In a seizure-free random sample of this population, 17 out of 118 (14.4%) subjects examined by CT and 10 out of 96 (10.4%) examined by EITB had evidence for this infection. The differences between the epilepsy group and the random sample of the population were statistically significant (OR 6.93, CI 2.7–17.5, p!
0.001) for CTdiagnosis, but not for EITB diagnosis (OR 2.75, CI 0.8–7.1, p1 0.12, NS