Epilepsy and neurocysticercosis in rural Tanzania-An imaging study.
OBJECTIVE
In developing countries, neurocysticercosis (NCC) is a common cause of epilepsy. Most of the work on NCC and epilepsy has been compiled in Latin America. To date, comprehensive neuroimaging studies are missing in sub-Saharan Africa.


METHODS
In our study, we interviewed 212 people with epilepsy (PWE) and performed cerebral computed tomography (CT) at the Haydom Lutheran Hospital in northern Tanzania. Control cerebral CT scans were selected from 198 consecutive individuals without epilepsy. Sera of PWE with lesions indicating NCC (n = 20), PWE without NCC lesions (n = 20), and healthy individuals (n = 20), as well as cerebrospinal fluid (CSF) samples of PWE with NCC lesions (n = 11) were investigated for anticysticercal antibodies.


RESULTS
Definite NCC lesions were present in five (2.4%), lesions highly suggestive of NCC in 24 (11.3%), and lesions compatible with NCC in nine (4.2%) PWE. This compares to two (1.0%) people with definite NCC lesions, two (1.0%) with lesions highly suggestive of, and six (2.9%) with lesions compatible with NCC in the control group. NCC lesions were significantly more frequent in PWE compared to controls (p < 0.0001). CT results, and serum and CSF analysis taken together, we diagnosed 22 (10.4%) individuals with probable and 7 (3.3%) with definitive NCC in our cohort of PWE.


CONCLUSIONS
For the first time in sub-Saharan Africa, we give evidence within a large-scale neuroimaging study that NCC, a so far neglected infectious disease, represents a major cause of epilepsy.
Winkler
Andrea Sylvia
AS
Department of Neurology, Ludwig-Maximilians-University, Munich, Germany. drawinkler@yahoo.com.au
Blocher
Joachim
J
Auer
Herbert
H
Gotwald
Thaddaeus
T
Matuja
William
W
Schmutzhard
Erich
E
D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000097:blood / Q000134:cerebrospinal fluid; D001921:Brain / Q000000981:diagnostic imaging / Q000469:parasitology; D004827:Epilepsy / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D020019:Neurocysticercosis / Q000150:complications* / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012424:Rural Population; D013636:Tanzania / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
D000906:Antibodies