title: Characteristics of mesial temporal lobe epilepsy associated with hippocampal sclerosis plus neurocysticercosis.
abstract: Recent observations suggest that neurocysticercosis (NCC) might act as an initial precipitating injury (IPI) causing mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS). A total of 191 patients from Brazil, a country in which NCC is endemic, were surgically treated for MTLE-HS, and subsequent findings for patients with MTLE-HS were compared with those of patients with MTLE-HS plus NCC. Seventy-one patients (37,2%) presented chronic findings of NCC (cNCC). MTLE-HS plus cNCC was significantly more common in women (O.R.=2.45; 95%CI=1.30-4.60; p=0.005), in patients with no history of classical forms of IPI (O.R.=2.67; 95%CI=1.37-5.18; p=0.004), and in those with bi-temporal interictal spikes on video-EEG (O.R.=2.00; 95%CI=1.07-3.73; p=0.03). Single cNCC lesions were observed to occur significantly more often on the same side as hippocampal sclerosis, a finding suggesting an anatomical relationship between NCC and MTLE-HS. Taken together, our results suggest that NCC may be a marker, or contributes to or even causes MTLE-HS. Based on our findings, we propose two distinct, non-excluding, and potentially synergistic mechanisms involved in the development of MTLE-HS in NCC, one of them being inflammatory-mediated, while the other is electrogenic-mediated. Taken together, our observations may provide further evidence suggesting a role of NCC in the genesis or development of MTLE-HS.
authors.affiliation: Center for Epilepsy Surgery (CIREP), Hospital das Clínicas de Ribeirão Preto, Department of Neurology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil; Basic Research and Advanced Investigations in Neurology (B.R.A.I.N.), Hospital de Clínicas de Porto Alegre, UFRGS,Porto Alegre, Brazil. Electronic address: mmbianchin@hotmail.com.
authors.forename: Marino M
authors.initials: MM
authors.lastname: Bianchin
authors.affiliation: Center for Epilepsy Surgery (CIREP), Hospital das Clínicas de Ribeirão Preto, Department of Neurology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil; Department of Neurosciences and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirao Preto, Brazil.
authors.forename: Tonicarlo R
authors.initials: TR
authors.lastname: Velasco
authors.affiliation: Center for Epilepsy Surgery (CIREP), Hospital das Clínicas de Ribeirão Preto, Department of Neurology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil; Department of Neurosciences and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirao Preto, Brazil.
authors.forename: Lauro
authors.initials: L
authors.lastname: Wichert-Ana
authors.affiliation: Center for Epilepsy Surgery (CIREP), Hospital das Clínicas de Ribeirão Preto, Department of Neurology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil; Department of Neurosciences and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirao Preto, Brazil.
authors.forename: Veriano
authors.initials: V
authors.lastname: Alexandre
authors.affiliation: Center for Epilepsy Surgery (CIREP), Hospital das Clínicas de Ribeirão Preto, Department of Neurology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil; Department of Radiology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: David
authors.initials: D
authors.lastname: Araujo
authors.affiliation: Center for Epilepsy Surgery (CIREP), Hospital das Clínicas de Ribeirão Preto, Department of Neurology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil; Department of Radiology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: dos Santos
authors.affiliation: Center for Epilepsy Surgery (CIREP), Hospital das Clínicas de Ribeirão Preto, Department of Neurology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil; Neurosurgery Division, Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo at Ribeirão Preto, Ribeirão Preto, Brazil.
authors.forename: Carlos G
authors.initials: CG
authors.lastname: Carlotti
authors.affiliation: Department of Neurosciences and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirao Preto, Brazil.
authors.forename: Osvaldo M
authors.initials: OM
authors.lastname: Takayanagui
authors.affiliation: Center for Epilepsy Surgery (CIREP), Hospital das Clínicas de Ribeirão Preto, Department of Neurology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil; Department of Neurosciences and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirao Preto, Brazil.
authors.forename: Américo C
authors.initials: AC
authors.lastname: Sakamoto
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002908:Chronic Disease; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D020019:Neurocysticercosis / Q000453:epidemiology* / Q000473:pathology; D012598:Sclerosis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D012737:Sex Factors; D014741:Video Recording
keywords: Cysticercosis; Epileptogenesis; Focal epilepsy; Hippocampal sclerosis; Initial precipitating injury