Historical perspective: The British contribution to the understanding of neurocysticercosis.

Neurocysticercosis, or brain infestation with the larval stage of Taenia solium, is the most common risk factor for epilepsy in many endemic regions of the world. Hardly any cases are seen in Western developed countries, including Britain. However, a sizeable number (n = 450) was seen among British soldiers returning from deputation to India, then a British colony, first reported by Col. MacArthur at the Queen Alexandria Military Hospital in 1931. Here, we review the influence of the perceptive observations of British Army medics on the understanding of the parasitic disorder. The majority of these people presented with epilepsy. Among the contributions of the army medics were establishing the diagnosis, initially by histological examination of subcutaneous and muscular infestation, and later by radiography, clarifying the prognosis and the role of medical and surgical treatments and uncovering the close relationship between the larval (cysticercosis) and adult (intestinal tapeworm) stages of T. solium.

A Personal Account Regarding the Origin and Evolution of Controversies in the Management of Neurocysticercosis.

A panel of experts from the Infectious Disease Society of America and The American Society of Tropical Medicine and Hygiene recently published guidelines for management of neurocysticercosis, showing that clinical manifestations as well as the stage of involution and the anatomical location of parasites must be taken into account before the start of a rational therapy. Soon thereafter, isolated opinions attempted to discredit these guidelines, arguing insufficient or inadequate evidence and suggesting that they should not be followed worldwide. In view of these conflicting reports, it is appropriate to review the origin and evolution of the controversy on the medical treatment of neurocysticercosis.

Did Antonio Vallisneri (1661-1730) really describe frontal sinus osteoma? Unexpected insights for paleo-neuroparasitology.

It has been believed for a long time that the Paduan scholar Antonio Vallisneri (1661-1730) described the second historical case of the frontal sinus osteoma in 1733. By historico-medically reexamining this case, we conclude that the brain concretions he described were not a case of frontal sinus osteoma, while they appear to have been pathological outcomes of neurocysticercosis, whose larval stages would only be described by Johann Goeze (1731-1793) later, in 1784. Thus, this case becomes relevant for the history of neuroparasitology.

Evaluating Healthcare Claims for Neurocysticercosis by Using All-Payer All-Claims Data, Oregon, 2010-2013.

To characterize the frequency of neurocysticercosis, associated diagnostic codes, and place of infection, we searched Oregon's All Payer All-Claims dataset for 2010-2013. Twice as many cases were found by searching inpatient and outpatient data than by inpatient data alone. Studies relying exclusively on inpatient data underestimate frequency and miss less severe disease.

Hospitalization frequency and charges for neurocysticercosis, United States, 2003-2012.

Neurocysticercosis, brain infection with Taenia solium larval cysts, causes substantial neurologic illness around the world. To assess the effect of neurocysticercosis in the United States, we reviewed hospitalization discharge data in the Nationwide Inpatient Sample for 2003-2012 and found an estimated 18,584 hospitalizations for neurocysticercosis and associated hospital charges totaling >US $908 million. The risk for hospitalization was highest among Hispanics (2.5/100,000 population), a rate 35 times higher than that for the non-Hispanic white population. Nearly three-quarters of all hospitalized patients with neurocysticercosis were Hispanic. Male sex and age 20-44 years also incurred increased risk. In addition, hospitalizations and associated charges related to cysticercosis far exceeded those for malaria and were greater than for those for all other neglected tropical diseases combined. Neurocysticercosis is an increasing public health concern in the United States, especially among Hispanics, and costs the US health care system a substantial amount of money.

The Brazilian contribution to the study of neurocysticercosis: Moses and Lange's role in cerebrospinal fluid diagnosis.

We report the seminal contributions of both Dr. Arthur Moses (Instituto Oswaldo Cruz, Rio de Janeiro), in 1911, and Dr. Oswaldo Lange (Faculdade de Medicina da USP, São Paulo), in 1940, to the diagnosis of neurocysticercosis (NC). Moses was the first person to report an immunologically based method for the diagnosis of NC, whereas Lange reported the cerebrospinal features of NC.

The Brazilian contribution to the study of neurocysticercosis: Moses and LangeÆs role in cerebrospinal fluid diagnosis

Descrevemos as contribuições pioneiras de Arthur Moses (Instituto Oswaldo Cruz, Rio de Janeiro) em 1911 e de Oswaldo Lange (Faculdade de Medicina da USP, São Paulo) em 1940, para o diagnóstico da neurocisticercose (NC). Moses fez a primeira descrição mundial de um método para o diagnóstico imunológico da NC e Lange fez a descrição da síndrome liquórica da NC.

[The ecstatic epilepsy of Teresa of Jesus]. / La epilepsia extática de Teresa de Jesús.

AIMS: Our aim is to define the ecstasies (raptures) of Teresa de Ahumada (Teresa of Jesus) and to link them with ecstasies recently identified as convulsive seizures (Dostoevsky s epilepsy, Saint Paul s disease, ecstatic epilepsy). DEVELOPMENT AND CONCLUSIONS: We review the Carmelite nun's pathography, with special attention given to the excellent detailed descriptions of her ecstasies. The stereotypic movements and comparison with similar cases leads us to consider them as being epileptic, possibly secondary to neurocysticercosis.

JMM, past and present. Cysticerci cellulosae of the brain. 1864.

While striving to serve the needs of the international biomedical community of today, we would also like to remember JMM's long past as a venue for medical research. JMM is the successor to the Berlin Clinical Weekly (Berliner Klinische Wochenschrift), established in 1864. Below are excerpts from the Berlin Clinical Weekly's May issue from a hundred and thirty-five years ago, giving hints about the challenges and solutions being addressed by medical research of the time. Following the excerpt is a commentary by Martin Zeitz and Thomas Schneider, experts in gastroenterology at the University Clinic Benjamin Franklin in Berlin, Germany.

Epilepsia Verminosa.

Epilepsy is a major public health threat in the developing world, with much higher prevalence and incidence rates than those observed in developed countries. At present, one of the most common causes for epilepsy worldwide is the parasitic worm, Taenia solium, and the associated neurocysticercosis (NCC) that may often result from this infestation. Worm infestation was already recognized as a cause of epilepsy by the middle of the 18th century. Helminths and their effects on health were a daily medical concern in the 18th and 19th centuries--with prevailing views ranging from the beneficial effects of the presence of adult worms in the gut, to considering them as culprits for a wide variety of diseases. A number of cases followed longitudinally by various nineteenth-century French physicians showed that there was good reason to believe that the verminous influence on seizures was real, as the expulsion of the T. solium often coincided with a notable amelioration of symptoms. Several theories were proposed to account for how the worms could lead to Epilepsia nervosa, including notions of competition for nutritional resources between the host and the parasite, and irritation of the medulla and of peripheral nerve endings predisposing to epileptiform episodes. Recently, after almost a century of quiet, interest in the neurological effects of helminths has been rekindled, due in part to the growing number of cases in the United States with NCC-related neurological disorders. In this article, we review the history of our understanding of the relationship between seizure disorders and parasitic worms, and we relate this history to contemporary epidemiologic and public health issues in developing countries.

[Neurocysticercosis in the South-East of France 1988-1998]. / Neurocysticercose dans le Sud-Est de la France entre 1988 et 1998.

OBJECTIVE: Neurocysticercosis is commonly observed in developing countries but can also occur in industrialized countries. The aim of this work was to analyze diagnostic and therapeutic data on cases of neurocysticercosis diagnosed in southeastern France over the last 10 years. METHODS: We collected data from patient files and compared them with those reported in the literature. RESULTS: We collected 29 cases of neurocysticercosis diagnosed in southeastern France between 1988 and 1999. None of the patients had acquired the disease in France. Seizures were the most common inaugural sign. Four patients had skin lesions and very few had radiologically identifiable muscle calcifications. CT scan and MRI provided the diagnosis of neurocysticercosis and contributed to follow-up. Brain imaging showed cyst formation and calcifications. Cysticercosis serology was positive in only 52% of our patients. Antiparasite treatments with albendazole provided improvement in most patients although aggravation was observed in 4 despite a well-conducted regimen. There was one death. CONCLUSION: Neurological manifestations, particularly seizures, in a patient returning from an endemic zone should prompt search for neurocysticercosis with brain CT and MRI. Regression of clinical and radiological signs with treatment confirms the diagnosis.