Serum and cerebrospinal fluid S100B concentrations in patients with neurocysticercosis

The clinical manifestations of neurocysticercosis (NC) are varied and depend on the number and location of cysts, as well as on the host immune response. Symptoms usually occur in NC when cysticerci enter a degenerative course associated with an inflammatory response. The expression of brain damage markers may be expected to increase during this phase. S100B is a calcium-binding protein produced and released predominantly by astrocytes that has been used as a marker of reactive gliosis and astrocytic death in many pathological conditions. The aim of the present study was to investigate the levels of S100B in patients in different phases of NC evolution. Cerebrospinal fluid and serum S100B concentrations were measured in 25 patients with NC: 14 patients with degenerative cysts (D), 8 patients with viable cysts (V) and 3 patients with inactive cysts. All NC patients, except 1, had five or less cysts. In most of them, symptoms had been present for at least 1 month before sample collection. Samples from 8 normal controls (C) were also assayed. The albumin quotient was used to estimate the blood-brain barrier permeability. There were no significant differences in serum (P = 0.5) or cerebrospinal fluid (P = 0.91) S100B levels among the V, D, and C groups. These findings suggest that parenchymal changes associated with a relatively small number of degenerating cysts probably have a negligible impact on glial tissue.

Diagnostico e tratamento da neurocisticercose / Diagnosis and treatment of neurocysticercosis

Objetivo: Estudo da neurocisticercose (NC) abrangendo o período 3 janeiro de 1980 a outubro de 2001 em pacientes atendidos nos hospitais Vera Cruz e Alberto Cavalcanti de Belo Horizonte - MG. Metodologia: foram estudados 398 pacientes, sendo que 318 apresentavam a forma inativa da doença e 80 a forma ativa. Em arte da casuística (32 pacientes) foi avaliado o efeito terapêutico a dexametazona associada a drogas parasiticidas sobre a forma ativa parenquimatosa da NC. Resultados: as manifestações clínicas mais frequentes foram a epilepsia (57,8%), hidrocefalia (11,0%) e hipertensão intracraniana (6,0%). Radiografia do crânio, tomografia computadorizada cerebral e ressonância magnética foram positivas para o diagnóstico da NC em 10,5%, 63,0% e 100,0% dos casos, respectivamente. Melhores resultados terapêuticos sobre a forma ativa parenquimatosa foram obtidos com a associação de corticosteróide com os parasiticidas. Conclusões: a classificação da NC em formas ativas e inativas é essencial para decidir a terapia. O tratamento com associação de corticosteróide e droga parasiticida mostrou-se mais eficaz para normas intra-parenquimatosas em relação ao uso exclusivo de corticostereóides. A NC não está erradicada em nosso meio.

The experience with 398 patients with neurocysticercosis during 20 years is reported. The inactive and active forms of the disease were diagnosed in 318 and 80 patients, respectively. The most frequent clinical manifestations were epilepsy (57.8%), hydrocephalus (11.6%) and intra-cranial hypertension (6.1%). Skull X-ray, cerebral computerized tomography, and magnetic resonance imaging were positive for the diagnosis of neurocysticercosis in 10.5%, 63.0% and 100% of the cases, respectively. In 32 patients with the active form of the disease the therapeutic effects of dexametasone alone (16 patients) and the combination of dexametasone and parasiticidal drugs (16 patients) were evaluated. Best therapeutic results were obtained with the combination of corticosteroids and parasiticidal drugs.

Manifestacioners radiológicas de la neurocistecercosis en los pacientes del hospital Escuela Antonio Lenin Fonseca febrero - diciembre deel 2004 / Radiological Manifestacioners of the neurocistecercosis in the patients of the hospital School Antonio Lenin Fonseca February - December deel 2004

Estudio descriptivo, transversal realizado en el servicio de Neurología del Hospital Escuela Antonio Lenin Fonseca, durante el período de febrero - diciembre del 2005, que incluyó a 69 pacientes con diagnóstico de Neurocisticercosis, con el objetivo de identificar las manifestaciones radiológicas de la enfermedad. La edad promedio fue el rango de 31- 40 años (27.54 por ciento), sin predominio por el sexo. El 56.5 por ciento de los pacientes procedian de áreas rurales. El tiempo de evolución de la neurocisticercosis en este estudio fue el comprendido entre 1 y 5 años, desde el inicio de la enfermedad y el diagnóstico. Las convulsiones fueron el hallazgo clínico más común (60.8 por ciento), seguido de la cefalea (24.6 por ciento). Se realizaron pruebas de diagnóstico auxiliares que incluyeron hemograma, coprológico, citoquímico del LCR y ELISA indirecto, cuyos resultados fueron de neurocisticercosis. El estudio de imagen con hallazgos sugerentes de neurocisticercosis fue 100 por ciento, La lesión más frecuente encontrada en este estudio fue el nódulo calcificado (80 por ciento), que corresponde al estadio evolutivo nodular calcificado (80 por ciento), siendo el parénquima cerebral el sitio de mayor afectación (94 por ciento). El 96 por ciento de los pacientes quedaron en la categoria diagnóstica de diagnóstico probable, cumpliendo con criterios ya establecidos...

The clinical spectrum of neurocysticercosis in the Uttaranchal region.

OBJECTIVES: To study the clinical and radiological spectrum of neurocysticercosis in the Uttaranchal region. METHODS: A total of 592 patients of neurocysticercosis attending various health camps, medical outdoor and indoor department were studied for their clinical and radiological presentation. RESULTS: Out of the total 15,000 patients screened, 592 patients (3.94%) were found to be suffering from neurocysticercosis. Majority of them were in the age group of 21-30 years. Most of them presented with generalized seizures (62.5%), others had headache (37.5%), focal seizures (20.8%), localizing neurological signs (16.6%), meningitis (4.1%), and dementia (1.3%). Radiologically, parenchymal lesions were most prevalent (81%). However, interventricular lesions were also not very uncommon (32%). Most of them had single lesions (53.5%), 26.7% had multiple lesions and 0.7% had midline shift. Significantly, large number of patients were vegetarians (39%); only 17.6% were pork eaters while the remaining 82.4% never had pork in their meals. CONCLUSION: We believe that such high percentage is at least a rough indicator of high incidence and prevalence of neurocysticercosis in the Uttaranchal region. They had wide range of clinical and radiological presentation. Small number of pork eaters and a significant number of vegetarians suggest other modes of transmission and needs further evaluation.