Volume 4, Number 38; October 06, 2005
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Volume 4, Number 38; October 06, 2005 |
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Can't quit staring...
Recommended reading:
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Patient: 24 year old male immigrant from India, with travel to Saudi Arabia, with 2 days of 'staring spells'. Family observed 6 instances on second day. Laboratory values essentially normal. Right frontal lobe lesions observed on CT and MRI. Brain biopsy of lesion revealed distinctive 'scalloped' edges to tissue in magnified cross-section.
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Session Handout:
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Clinical Question: 1) How common is neurocysticercosis in the United States, and how is it diagnosed?
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Readings:
Link Directly to Fulltext article in Ovid <1> Unique Identifier [PMID]: 15534236 Authors: Wallin MT. Kurtzke JF. Institution: Neuroepidemiology Section, Neurology Service, Georgetown University School of Medicine, Department of Veterans Affairs Medical Center, Washington, DC 20007, USA. mitchell.wallin@med.va.gov Title: Neurocysticercosis in the United States: review of an important emerging infection.[see comment]. [Review] [51 refs]
Source: Neurology. 63(9):1559-64, 2004 Nov 9. Abstract: OBJECTIVE: To review published clinical studies on neurocysticercosis (NCC) in the United States over the past two decades and comment on epidemiologic trends and treatment. METHODS: This review is based on a search of the literature citing NCC cases diagnosed in the United States utilizing PUBMED for the years 1980 through early 2004. Case series, case reports, epidemiologic studies, and treatment of NCC were evaluated. RESULTS: A total of 1,494 patients with NCC were reported in the United States among large case series (n > 20) between 1980 and early 2004. Common onset symptoms for these patients included seizures (66%), hydrocephalus (16%), and headaches (15%). The majority presented with parenchymal NCC (91%), with the remainder having ventricular cysts (6%), subarachnoid cysts (2%), and spinal cysts (0.2%). A total of 76 cases of NCC were likely acquired within the United States during the period of this review. A higher risk for acquiring NCC has been documented in patients who have traveled to endemic regions, are of Hispanic ethnicity, and have contact with Taenia solium tapeworm carriers. CONCLUSIONS: An increasing number of NCC cases have been reported in the US literature over the past 50 years, suggesting that the prevalence of this disease may be on the rise. Because neurologists are often involved with the diagnosis and management of NCC in the United States, it is important that they become familiar with this disorder, as they will play an important role in efforts to control the disease. [References: 51] Publication Type: Journal Article. Review. Review, Tutorial.
Link Directly to Fulltext Article at Publisher <3> Unique Identifier [PMID]: 15728858 Authors: Garcia HH. Del Brutto OH. Nash TE. White AC Jr. Tsang VC. Gilman RH. Institution: Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru. hgarcia@jhsph.edu Title: New concepts in the diagnosis and management of neurocysticercosis (Taenia solium). [Review] [54 refs]
Source: American Journal of Tropical Medicine & Hygiene. 72(1):3-9, 2005 Jan. Abstract: Human neurocysticercosis, the infection of the nervous system by the larvae of Taenia solium, is a major cause of epileptic seizures and other neurologic morbidity worldwide. The diagnosis and treatment of neurocysticercosis have been considerably improved in recent years. This improvement includes identification and sequencing of specific antigens and development of new assays for laboratory diagnosis, recognition of the frequency and significance of edema around old, calcified cysts (associated to symptomatic episodes), results of a randomized blinded control treatment trial on treatment efficacy for intraparenchymal disease showing a clinical benefit of decreased seizures, and a much better assessment of the frequency and spectrum of cerebrovascular complications. These advances now permit a much better integration of clinical, serologic, and imaging data for diagnosis and therapeutic purposes. [References: 54] Publication Type: Journal Article. Review. Review, Tutorial.
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Resident Report / Department of Medicine & Grady Branch Library Emory University School of Medicine 2005 Edition Participating Faculty: Carlos Del Rio MD / Joyce Doyle MD / Lorenzo Difrancesco MD / Erich Folch MD / Alicia Hidron MD
Contact:
Karl Woodworth
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