title: Update on Cysticercosis Epileptogenesis: the Role of the Hippocampus.
abstract: Neurocysticercosis (NCC) is the most common helminthic infection of the nervous system and a frequent cause of reactive seizures and epilepsy worldwide. In many cases, multiple episodes of focal seizures related to an identifiable parenchymal brain cyst (and likely attributable to local damage) continue for years after the cyst resolves. However, cases where seizure semiology, interictal EEG abnormalities, and parasites location do not correlate raise concerns about the causal relationship between NCC and either reactive seizures or epilepsy, as well as the epileptogenic potential of parasites. Neurosurgical series of patients with intractable epilepsy and cross-sectional population-based studies have shown a robust association between NCC and hippocampal sclerosis (HS), which might contribute to the above-referred inconsistencies. Current information does not allow to define whether in patients with NCC, HS could result from recurrent seizure activity from a local or distant focus or from chronic recurrent inflammation. In either case, HS may become the pathological substrate of subsequent mesial temporal lobe epilepsy (MTLE). Longitudinal clinical- and population-based cohort studies are needed to evaluate the causal relationship between NCC and HS and to characterize this association with the occurrence of MTLE. If a cause-and-effect relationship between NCC and HS is demonstrated, NCC patients could be assessed to examine neuronal mechanisms of hippocampal epileptogenesis in comparison with animal models, to identify biomarkers of hippocampal epileptogenesis, and to develop novel interventions to prevent epilepsy in NCC and perhaps in other forms of acquired epilepsy.
authors.affiliation: School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador. oscardelbrutto@hotmail.com.|, Air Center 3542, PO Box 522970, Miami, FL, 33152-2970, USA. oscardelbrutto@hotmail.com.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Del Brutto
authors.affiliation: Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: Jerome
authors.initials: J
authors.lastname: Engel
authors.affiliation: Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: Dawn S
authors.initials: DS
authors.lastname: Eliashiv
authors.affiliation: Center for Global Health, Tumbes and the Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru.|Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Hector H
authors.initials: HH
authors.lastname: García
mesh_terms: D000818:Animals; D004827:Epilepsy / Q000209:etiology / Q000503:physiopathology*; D006624:Hippocampus; D006801:Humans; D020019:Neurocysticercosis / Q000150:complications; D012598:Sclerosis / Q000150:complications; D012640:Seizures / Q000503:physiopathology
keywords: Cysticercosis; Epilepsy; Hippocampal sclerosis; Hippocampus; Neurocysticercosis; Seizures