Neurocisticercosis y epilepsia en Cuba

Abstract

Neurocysticercosis is one of the main causes of epilepsy in the tropics, particularly in Central and South America. To report the only five patients diagnosed in a tertiary care institution as having neurocysticercosis and its relation to epilepsy. We made a retrospective study, reviewing the clinical histories of patients admitted to the Instituto de Neurologia y Neurocirugia of La Habana, Cuba, over 25 years up to 1989, to determine those with neurocysticercosis. We found only five patients, representing a frequency of 0.01% of all admissions. We discuss the origin of these cases and their possible place of infection, showing that this is almost non-existent in Cuba since three of the cases were of foreigners and there was evidence that the two Cubans had acquired the disease abroad. The correlation between neurocysticercosis and epilepsy (4 of 5 cases) was assessed. The main symptoms were analyzed: the three most important, in order, were tonic-clonic convulsions, headache and motor deficit respectively. The epileptic seizures were classified as secondary generalized partial seizures (symptomatic partial epilepsy secondary to cysticercosis). The clinical form, when the site is considered, was inactive, with intraparenchymatous and meningeal (mixed) calcifications in one case. We assess the elements which permit diagnosis, the efficacy of anti-helminth treatment and the drugs used to treat epilepsy and cerebral oedema, the prognosis as a function of the diagnosis and the treatment.