title: Neurocysticercosis as a cause of epilepsy and seizures in two community-based studies in a cysticercosis-endemic region in Peru.
abstract: BACKGROUND
  The prevalence of epilepsy added to inadequate treatment results in chronic morbidity and considerable mortality in poor populations. Neurocysticercosis (NCC), a helminthic disease of the central nervous system, is a leading cause of seizures and epilepsy in most of the world.
  
  
  METHODS
  Taking advantage of a cysticercosis elimination program, we performed two community-based cross-sectional studies between 2006 and 2007 in 58 rural communities (population 20,610) to assess the prevalence and characteristics of epilepsy and epileptic seizures in this endemic region. Serological and computed tomography (CT) data in individuals with epilepsy were compared to previous surveys in general population from the same region.
  
  
  RESULTS
  In two surveys, 17,450 individuals were evaluated. Lifetime prevalence of epilepsy was 17.25/1000, and prevalence of active epilepsy was 10.8/1000 inhabitants. The prevalence of epilepsy increased after age 25 years and dropped after age 45. Only 24% (45/188) of patients with active epilepsy were taking antiepileptic drugs, all at sub-therapeutic doses. Antibodies to cysticercosis were found in approximately 40% of individuals with epilepsy in both studies. In one survey only individuals presenting strong antibody reactions were significantly associated with having epilepsy (OR 5.74; p<0.001). In the second, the seroprevalence as well as the proportion presenting strong antibody reactions were both significantly higher in individuals with epilepsy (OR 2.2 and 4.33, respectively). Brain CT showed NCC-compatible images in 109/282 individuals with epilepsy (39%). All individuals with viable parasites on CT were seropositive.
  
  
  CONCLUSIONS
  The prevalence of epilepsy in this cysticercosis endemic region is high and NCC is an important contributor to it.
authors.affiliation: Cysticercosis Elimination Program and Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Perú
authors.forename: Luz M
authors.initials: LM
authors.lastname: Moyano
authors.affiliation: Cysticercosis Elimination Program and Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Perú ; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Mayuko
authors.initials: M
authors.lastname: Saito
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Lima, Perú
authors.forename: Silvia M
authors.initials: SM
authors.lastname: Montano
authors.affiliation: Cysticercosis Elimination Program and Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Perú
authors.forename: Guillermo
authors.initials: G
authors.lastname: Gonzalvez
authors.affiliation: Cysticercosis Elimination Program and Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Perú
authors.forename: Sandra
authors.initials: S
authors.lastname: Olaya
authors.affiliation: Cysticercosis Elimination Program and Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Perú
authors.forename: Viterbo
authors.initials: V
authors.lastname: Ayvar
authors.affiliation: Instituto de Ciencias Neurológicas, Lima, Perú
authors.forename: Isidro
authors.initials: I
authors.lastname: González
authors.affiliation: Instituto de Ciencias Neurológicas, Lima, Perú
authors.forename: Luis
authors.initials: L
authors.lastname: Larrauri
authors.affiliation: Georgia State University, Atlanta, Georgia, United States of America.
authors.forename: Victor C W
authors.initials: VC
authors.lastname: Tsang
authors.affiliation: School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Perú
authors.forename: Fernando
authors.initials: F
authors.lastname: Llanos
authors.affiliation: Instituto de Ciencias Neurológicas, Lima, Perú
authors.forename: Silvia
authors.initials: S
authors.lastname: Rodríguez
authors.affiliation: School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú
authors.forename: Armando E
authors.initials: AE
authors.lastname: Gonzalez
authors.affiliation: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.affiliation: Cysticercosis Elimination Program and Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Perú ; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America ; Instituto de Ciencias Neurológicas, Lima, Perú ; Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú
authors.forename: Hector H
authors.initials: HH
authors.lastname: Garcia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019353:Endemic Diseases; D004827:Epilepsy / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000150:complications / Q000453:epidemiology*; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population; D055815:Young Adult