Abstracts

Observations in our population indicate that in endemic areas to neurocysticercosis (NCC), NCC is more common in patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS) than in other forms of focal medically intractable epilepsy, suggesting a possible association between these two diseases. We designed this study in order to further explore this association., Retrospective cohort of 191 patients with MTLE-HS from Brazil. We evaluated demographic, clinical, and neuroimaging findings of patients with MTLE-HS plus NCC and compared them with those of patients with MTLE-HS without NCC. The magnitude of differences was measured by the O.R. (95% C.I.). Adjusted O.R. was estimated by logistic regression. Logistic regression was also used to predicting NCC in MTLE-HS patients., We observed chronic NCC radiological findings in 68 (35.6%) MTLE-HS patients. In these patients, NCC was significantly more common in women (45 patients 45.9%) than in men (23 patients, 24.7%), (adjusted O.R. = 3.33; 95% C.I. =1.67-6.62 [italic]p[/italic][lt]0.001), in patients with no history of an initial precipitating injury (IPI) before 5 years-old, (adjusted O.R. = 3.04; 1.38-6.72; [italic]p[/italic][lt]0.01), and in patients presenting bilateral temporal interictal spikes during pre-surgical video-EEG, (adjusted O.R. = 2.36; 95% C.I. =1.19-4.66; [italic]p[/italic][lt]0.02). In endemic areas similar to ours, the possibility of finding NCC in refractory MTLE-HS (Prob(NCC) can be calculated by the following equation: Prob(NCC) = 1/(1+e^-v), where V=(-0.038 [ndash] 1.2sex + 1.304IPI + 0.95iEEG). This equation was able to correctly predict the presence of neuroimaging findings of NCC in 71% of our surgical MTLE-HS patients., Taken together, our results suggest that NCC might be associated with epileptogenesis in mesial temporal lobe epilepsy in susceptible patients, thus being a possible risk factor for development of MTLE-HS. Indeed, if such association were only coincidental, occurring because of the relative high prevalence of both pathologies in the same region, differences between these two groups of patients were expected to be null. However, some important differences were observed and some associations were possible. Differences were observed for women, for those patients without an IPI history before 5 years-old, and for those patients with bi-temporal interictal EEG spikes. These results might help us to better understand the interactions between NCC and MTLE-HS, improving our insights on the possible factors that might explain the association of NCC and refractory MTLE-HS in some world areas., (Supported by FAPESP.)