title: Neurocysticercotic Calcifications and Hippocampal Sclerosis: A Case-Control Study.
abstract: OBJECTIVE
  The exact role of calcified neurocysticercotic lesions (CNLs) in epilepsy is yet unknown and controversial. Although the relationship between CNLs, epilepsy and mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) has already been addressed, to our knowledge, no study has actually provided strong statistical evidence, nor reported the ODDS ratio for these associations. Therefore, we designed this case-control study to assess the likelihood of having MTLE-HS versus other forms of epilepsy in the presence of CNLs.
  
  
  METHODS
  In this case-control study we included 119 consecutive patients with epilepsy and 106 disease controls (headache) with previous CT scans. We subdivided cases into MTLE-HS and other epilepsies. We used brain CT scans to define presence or absence of CNLs. After exploratory analyses, we used logistic regression to analyze the association between CNLs, epilepsy subgroups and disease controls.
  
  
  RESULTS
  CNLs were found in 31.09% of cases and in 11.32% of controls (p<0.001). The initial analysis comparing epilepsy versus controls revealed a significant association between CNLs and epilepsy (OR = 5.32; 95%CI = 2.43-11.54; p<0.001). However, when we compared MTLE-HS versus other epilepsies versus controls we confirmed that CNLs were associated with MTLE-HS (OR = 11.27, 95%CI = 4.73-26.85; p<0.001) but other epilepsies were not. We found no difference in the CNLs load and no difference in the location of the CNLs when we compared patients with MTLE-HS, other epilepsies and disease controls.
  
  
  CONCLUSIONS
  The inclusion of controls allowed us to estimate the likelihood of having epilepsy in the presence of CNLs. We found that patients with CNLs were 11 times more likely to have MTLE-HS; however, the presence of CNLs did not change the odds of having other types of epilepsy. These findings raise the possibility of neurocysticercosis playing a role in the pathophysiology of MTLE-HS and need further confirmation in other series.
authors.affiliation: School of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil.
authors.forename: Mateus
authors.initials: M
authors.lastname: de Oliveira Taveira
authors.affiliation: Department of Neurology, University of Campinas-UNICAMP, Campinas, SP, Brazil.
authors.forename: Marcia Elisabete
authors.initials: ME
authors.lastname: Morita
authors.affiliation: Department of Neurology, University of Campinas-UNICAMP, Campinas, SP, Brazil.
authors.forename: Clarissa Lin
authors.initials: CL
authors.lastname: Yasuda
authors.affiliation: Department of Neurology, University of Campinas-UNICAMP, Campinas, SP, Brazil.
authors.forename: Ana Carolina
authors.initials: AC
authors.lastname: Coan
authors.affiliation: Department of Medical Genetics, University of Campinas-UNICAMP, Campinas, SP, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Secolin
authors.affiliation: Department of Neurology, University of Campinas-UNICAMP, Campinas, SP, Brazil.
authors.forename: Alberto
authors.initials: A
authors.lastname: Luiz Cunha da Costa
authors.affiliation: Department of Neurology, University of Campinas-UNICAMP, Campinas, SP, Brazil.
authors.forename: Fernando
authors.initials: F
authors.lastname: Cendes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000469:parasitology; D016022:Case-Control Studies; D004827:Epilepsy / Q000209:etiology / Q000469:parasitology; D005260:Female; D006624:Hippocampus / Q000469:parasitology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D059906:Neuroimaging; D012598:Sclerosis; D014057:Tomography, X-Ray Computed; D055815:Young Adult