A Large Cohort of Neurocysticercosis in Shandong Province, Eastern China, 1997-2015

Xiaodan Huang, Zhonglei Wang, Jingxuan Kou, Hongmei Liu, Dehua Mao, Zhenhua Yu, Xin Liu, Peng Cheng, Maoqing Gong, Xiaodan Huang, Zhonglei Wang, Jingxuan Kou, Hongmei Liu, Dehua Mao, Zhenhua Yu, Xin Liu, Peng Cheng, Maoqing Gong

Abstract

Neurocysticercosis (NCC) has a wide spectrum of neurologic and psychiatric manifestations, including epileptic seizures, high intracranial pressure, cognitive dysfunction, and meningoencephalitis. This study presents the clinical diagnosis of 2539 NCC patients in Shandong Province, Eastern China, from 1997 to 2015. The diagnosis was based primarily on clinical features, neuroimaging, immunology, and electroencephalogramy studies. In all age groups, seizures were found to be the most common manifestation, followed by headaches, memory loss, and limb numbness, and disability. After antiparasitic treatment, computed tomography and magnetic resonance imaging showed that most of the lesions had been completely absorbed in 2106 (82.95%) patients, most of the lesions had been absorbed and a small proportion was converted into calcifications in 433 (17.05%) cases. Indirect hemagglutination (IHA), enzyme-linked immunosorbent assay (ELISA), and circulating antigen (CAg) serum tests initially gave 76.45%, 86.37%, and 80.66% positive results, respectively. After antiparasitic therapy, the positive rates of the IHA, ELISA, and CAg tests were 74.77%, 84.70%, and 3.75%, respectively, showing no significant difference in antibody levels (p > 0.05), but a significant difference in CAg levels (p < 0.01). The clinical antiparasitic treatment of NCC with three to four courses of a combination of albendazole and praziquantel achieved satisfactory therapeutic efficacy.

Keywords: albendazole; and praziquantel; clinical features; diagnosis; neurocysticercosis.

Conflict of interest statement

No conflicting financial interests exist.

Figures

FIG. 1.
FIG. 1.
Different sites of NCC. Pariental NCC (A, B), frontal NCC (C), temporal NCC (D), cerebellar NCC (E), and intraventricular NCC (F). NCC, neurocysticercosis.
FIG. 2.
FIG. 2.
Computed tomography image of NCC before treatment (A) and 1 year after the antiparasitic treatment (B).

References

    1. Botero D, Uribe CS, Sanchez JL, Alzate T, et al. . Short course albendazole treatment for neurocysticercosis in Columbia. Trans R Soc Trop Med Hyg 1993; 87:576–577
    1. Cangalaya C, Bustos JA, Calcina J, Vargas CA, et al. . Radiological evolution of porcine neurocysticercosis after combined antiparasitic treatment with praziquantel and albendazole. PLoS Negl Trop Dis 2017; 11:e0005624.
    1. Cao WC, Xu JF. Epidemiological survey on Taenia solium and cysticercus sac infection in Shandong Province, China. Chin J Parasit Dis Control 1995; 8:168–172
    1. Carabin H, Ndimubanzi PC, Budke CM, Nguyen H, et al. . Clinical manifestations associated with neurocysticercosis: A systematic review. PLoS Negl Trop Dis 2011; 5:e1152.
    1. Coyle CM, Mahanty S, Zunt JR, Wallin MT, et al. . Neurocysticercosis: Neglected but not forgotten. PLoS Negl Trop Dis 2012; 6:e1500.
    1. Del Brutto OH. Diagnostic criteria for neurocysticercosis, revisited. Pathog Glob Health 2012; 106:299–304
    1. Del Brutto OH, Roos KL, Coffey CS, Garcia HH. Meta-analysis: Cysticidal drugs for neurocysticercosis: Albendazole and praziquantel. Ann Intern Med 2006; 145:43–51
    1. Feng XC, Shen YP. The detection of circulatng antigen of parasitic infection and its application. J Pathog Biol 1989; 2:110–113
    1. Feng YK. Clinical Electroencephalography. Beijing: People's Health Publishing House, 1980:61–64
    1. Garcia HH, Gonzales I, Lescano AG, Bustos JA, et al. . Efficacy of combined antiparasitic therapy with praziquantel and albendazole for neurocysticercosis: A double-blind, randomised controlled trial. Lancet Infect Dis 2014; 14:687–695
    1. Garcia HH, Lescano AG, Gonzales I, Bustos JA, et al. . Cysticidal efficacy of combined treatment with praziquantel and albendazole for parenchymal brain cysticercosis. Clin Infect Dis 2016; 62:1375–1379
    1. Garcia HH, Pretell EJ, Gilman RH, Martinez SM, et al. . A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis. N Engl J Med 2004; 350:249–258
    1. Ge LY, He PJ, Cao YC, Wang ZH, et al. . Histopathological observation on cysticercus cellulosae aftek treatment with ganwupulvis, a Chinese traditional medicine. J Pathog Biol 1991; 4:22–23
    1. Jia FJ, OY AM, Wu XY, Hu YX, et al. . Change of CT image and clinical significance in cerebral cysticercosis treated by PQT and PQT with dose increasing method. Bull Dis Control Prev 2005; 20:7–9
    1. Jia FJ, Wu XY, Dai W, Sun GP, et al. . Analysis of CT image and effect of anti-cysticercus therapy for 300 patients with cerebral cysticercosis. Chin J Schisto Control 2003; 15:282–284
    1. Li CM, Li CX. Clinical observation on 116 cerebral cysticercosis patients treated with big dosage of praziquantel. Chin J Int Med 1998; 37:474
    1. Li YH. Parasitology Immunology and Immunodiagnosis. Nanjing, China: Jiangsu Science and Technology Press, 1991:55
    1. Liu X, Deng XL, Zhao ZP, Wan GQ, et al. . Epidemiological studies on taeniasis and cysticercosis in the middle part of Shandong province. Chin J Parasit Dis Control 2000; 3:34–36
    1. Ma Y, Zhu J, Liu Z. A clinical study on the treatment of cerebral cysticercosis with praziquantel. Natl Med J China 1984; 64:79–83
    1. Montano SM, Villaran MV, Ylquimiche L, et al. . Neurocysticercosis: association between seizures, serology and brain CT in rural Peru. Neurology 2005; 65:229–233
    1. Mwanjali G, Kihamia C, Kakoko DV, Lekule F, et al. . Prevalence and risk factors associated with human Taenia solium infections in Mbozi District, Mbeya Region, Tanzania. PLoS Negl Trop Dis 2013; 7:e2102.
    1. Nash TE, Pretell EJ, Lescano AG, Bustos JA, et al. . Perilesional brain oedema and seizure activity in patients with calcified neurocysticercosis: A prospective cohort and nested case-control study. Lancet Neurol 2008; 7:1099–1105
    1. Nash TE, Garcia HH. Diagnosis and treatment of neurocysticercosis. Nat Rev Neurol 2011; 7:584–594
    1. Ndimubanzi PC, Carabin H, Budke CM, Nguyen H, et al. . A systematic review of the frequency of neurocyticercosis with a focus on people with epilepsy. PLoS Negl Trop Dis 2010; 4:e870.
    1. Roman G, Sotelo J, Del Brutto O, Flisser A, et al. . A proposal to declare neurocysticercosis an international reportable disease. Bull World Health Organ 2000; 78:399–406
    1. Sierra MM, Arroyo M, Torres MC, Cruz NR, et al. . Extraparenchymal neurocysticercosis: Demographic, clinicoradiological and inflammatory features. PLoS Negl Trop Dis 2017; 11:e0005646.
    1. Singh SK, Prasad KN, Singh AK, Gupta KK, et al. . Adhesion molecules, chemokines and matrix metallo-proteinases response after albendazole and albendazole plus steroid therapy in swine neurocysticercosis. Exp Parasitol 2017; 182:1–8
    1. Sotelo J, Del Brutto OH, Penagos P, Escobedo F, et al. . Comparison of therapeutic regimen of anticysticercal drugs for parenchymal brain cysticercosis. J Neurol 1990; 237:69–72
    1. Sorvillo F, Wilkins P, Shafir S, Eberhard M. Public health implications of cysticercosis acquired in the United States. Emerg Infect Dis 2011; 17:1–6
    1. Su RN, Si Q. Clinical observation on the efficacy and side-effects of praziquantel treatment in 6480 cases of cysticercosis. Chin J Parasitol Parasit Dis 2002; 20:320
    1. Wandra T, Swastika K, Dharmawan NS, Purba IE, et al. . The present situation and towards the prevention and control of neurocysticercosis on the tropical island, Bali, Indonesia. Parasit Vectors 2015; 8:148.
    1. Wang ZL, Kou JX, Hu YX, Liu YL, et al. . Clinical observation on the effect of combined use of praziquantel and albendazole on cerebral cysticercosis. China Trop Med 2008; 8:1873–1876
    1. Wu EH. Head CT Diagnostic. Beijing: People's Medical Publishing House, 1995:146
    1. Wu W, Jia FJ, Wang W, Huang Y, et al. . Antiparasitic treatment of cerebral cysticercosis: Lessons and experiences from China. Parasitol Res 2013; 112:2879–2890
    1. Xu HX, Yin KX, Xu J, Liu YB. Study on measures to alleviate the sequelae of cerebral cysticercosis. Chin J Dis Control Prev 2002; 17:69–72
    1. Zhai CS, Wang YS, Shi ZL. Study on the detection of circulating antigen of patients with cysticercosis by ELISA. J Pathog Biol 1993; 6:16–18
    1. Zhen TM, Yang YJ, Li DJ, Ge LY, et al. . Diagnosis of cysticercosis. Diagnostic criteria of the health industry in the People's Republic of China 2012; WS381:1–14
    1. Zhu SX, Diao WZ, He ZY. Clinical treatment of cerebral cysticercosis (analysis of 420 cases). Acta Acad Med Hebei 2002; 13:145–147

Source: PubMed

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