Epilepsy and neurocysticercosis in rural Bolivia: a population-based survey.
OBJECTIVE
To evaluate the frequency of neurocysticercosis (NCC) in a well-defined prevalent cohort of epilepsy patients in the rural area of the Cordillera province.


METHODS
We carried out a two-phase door-to-door neuroepidemiologic survey in a sample of 10,124 subjects in a rural area of the Cordillera Province, Bolivia, to detect the prevalence of the most common neurologic disorders including epilepsy. A team of health workers administered a standard screening instrument for neurologic diseases; subjects found positive at the screening phase underwent a complete neurologic examination. Epilepsy patients were diagnosed according to the definition proposed by the International League Against Epilepsy (ILAE, 1993). Epilepsy patients identified this way underwent electroencephalographic recording, computed tomography (CT) scan, and serologic evaluation to detect antibodies against Taenia solium by enzyme-linked immunoelectrotransfer blot.


RESULTS
At the end of the survey, we detected 124 defined prevalent epilepsy patients. On the basis of the classification proposed by the ILAE in 1981, partial seizures were the most common type diagnosed (66 patients, 53.3%). Of the 124 patients, 105 underwent CT scan, and a serum sample was taken to detect antibodies against T. solium in 112 patients; for 97 patients, both neuroradiologic and serologic data were available. Considering radiologic, serologic, and clinical features, of these 124 patients, 34 (27.4%) fulfilled the diagnostic criteria for definitive or probable NCC proposed in 2001. Of these 34 patients 24 (70.6%) had partial seizures.


CONCLUSIONS
Our data confirm a high frequency of NCC among a well-defined prevalent cohort of epilepsy patients.
Nicoletti
Alessandra
A
Department of Neurosciences, University of Catania, Via S. Sofia no. 78, 95125 Catania, Italy. anicolt@unict.it
Bartoloni
Alessandro
A
Sofia
Vito
V
Bartalesi
Filippo
F
Chavez
Josè Rosado
JR
Osinaga
Rimberto
R
Paradisi
Franco
F
Dumas
Jean-Luc
JL
Tsang
Victor C W
VC
Reggio
Arturo
A
Hall
Andrew J
AJ
D001838:Bolivia / Q000453:epidemiology; D015331:Cohort Studies; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000453:epidemiology; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D020019:Neurocysticercosis / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*