title: Neurocysticercosis in travelers: a nation-wide study in Israel.
abstract: BACKGROUND
  Cysticercosis, a human infestation by Taenia solium is endemic in many resource-limited countries. In developed countries it is mostly encountered among immigrant populations. Only few cases are reported in travelers. This report summarizes a nation-wide study of neurocysticercosis (NCC) diagnosed among Israeli travelers to endemic countries, with an estimation of disease incidence among the traveler population.
  
  
  METHODS
  We performed a retrospective, nation-wide survey of travel-related NCC in Israel between the years 1994 and 2009.
  
  
  RESULTS
  Nine cases of NCC were diagnosed in Israeli travelers during the study years. Most patients had traveled to South and/or Southeast Asia. The most common symptom at diagnosis was a seizure. The average interval between return from the suspected travel and symptom onset was 3.2 ± 1.8 years. Two patients suffered from multiple lesions, whereas the rest had a single lesion. Antihelminthic treatment was given to most patients with resolution of symptoms. Median duration of antiepileptic treatment was 16 ± 41 months after albendazole was given. Antiepileptic treatment was discontinued without any complications. The estimated attack rate of clinical disease was 1 : 275,000 per travel episode to an endemic region.
  
  
  CONCLUSIONS
  NCC in travelers is a rare phenomenon commonly presenting as seizure disorder manifesting months to years post-travel. Antihelminthic therapy followed by 12 to 24 months of antiepileptic therapy resulted in complete resolution of symptoms in our patients.
authors.affiliation: Center for Geographic Medicine and Department of Medicine C, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Leshem
authors.forename: Iris
authors.initials: I
authors.lastname: Kliers
authors.forename: Mati
authors.initials: M
authors.lastname: Bakon
authors.forename: Moshe
authors.initials: M
authors.lastname: Gomori
authors.forename: Rebekah
authors.initials: R
authors.lastname: Karplus
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D001208:Asia; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy / Q000469:parasitology*; D041201:Taenia solium; D014195:Travel; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D000927:Anticonvulsants; D015766:Albendazole