title: Toxoplasmosis and epilepsy--systematic review and meta analysis.
abstract: BACKGROUND
  Toxoplasmosis is an important, widespread, parasitic infection caused by Toxoplasma gondii. The chronic infection in immunocompetent patients, usually considered as asymptomatic, is now suspected to be a risk factor for various neurological disorders, including epilepsy. We aimed to conduct a systematic review and meta-analysis of the available literature to estimate the risk of epilepsy due to toxoplasmosis.
  
  
  METHODS
  A systematic literature search was conducted of several databases and journals to identify studies published in English or French, without date restriction, which looked at toxoplasmosis (as exposure) and epilepsy (as disease) and met certain other inclusion criteria. The search was based on keywords and suitable combinations in English and French. Fixed and random effects models were used to determine odds ratios, and statistical significance was set at 5.0%.
  
  
  RESULTS
  Six studies were identified, with an estimated total of 2888 subjects, of whom 1280 had epilepsy (477 positive for toxoplasmosis) and 1608 did not (503 positive for toxoplasmosis). The common odds ratio (calculated) by random effects model was 2.25 (95% CI 1.27-3.9), p = 0.005.
  
  
  CONCLUSIONS
  Despite the limited number of studies, and a lack of high-quality data, toxoplasmosis should continue to be regarded as an epilepsy risk factor. More and better studies are needed to determine the real impact of this parasite on the occurrence of epilepsy.
authors.affiliation: INSERM, UMR1094, Neuroépidémiologie Tropicale, Limoges, France; Université de Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; Département d'Epidémiologie-Biostatistiques et Informatique Médicale (DEBIM/EA NEMIT), Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon.
authors.forename: Edgard B
authors.initials: EB
authors.lastname: Ngoungou
authors.affiliation: INSERM, UMR1094, Neuroépidémiologie Tropicale, Limoges, France; Université de Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France.
authors.forename: Devender
authors.initials: D
authors.lastname: Bhalla
authors.affiliation: Département d'Epidémiologie-Biostatistiques et Informatique Médicale (DEBIM/EA NEMIT), Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon.
authors.forename: Amandine
authors.initials: A
authors.lastname: Nzoghe
authors.affiliation: INSERM, UMR1094, Neuroépidémiologie Tropicale, Limoges, France; Université de Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; CHU Limoges, Laboratoire de Parasitologie-Mycologie, Limoges, France.
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Dardé
authors.affiliation: INSERM, UMR1094, Neuroépidémiologie Tropicale, Limoges, France; Université de Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; CHU Limoges, CEBIMER, Limoges, France.
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Preux
mesh_terms: D002908:Chronic Disease; D004827:Epilepsy / Q000150:complications / Q000453:epidemiology* / Q000469:parasitology; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D014122:Toxoplasma / Q000472:pathogenicity; D014123:Toxoplasmosis / Q000453:epidemiology* / Q000209:etiology / Q000469:parasitology