Epilepsy and neurocysticercosis in Atahualpa:: A door-to-door survey in rural coastal Ecuador
Epilepsy and neurocysticercosis in Atahualpa:: A door-to-door survey in rural coastal Ecuador
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DOI：
10.1111/j.0013-9580.2005.36504.x
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发表时间：
2005-04-01
期刊：
影响因子：
5.6
通讯作者：
García, HH
中科院分区：
文献类型：
--
作者：
Del Brutto, OH;Santibáñez, R;García, HH
目的：了解阿塔瓦尔帕市癫痫的患病率及脑囊虫病在癫痫发病中的作用。方法：采用入户调查的方法，对癫痫患者进行抽查，采集血样进行抗囊虫抗体检测，并评估人群的社会特征，包括家庭养猪情况。神经学家检查了疑似病例和阴性个体的样本。然后对癫痫患者以及年龄和性别匹配的对照组进行头部CT和头皮EEG检查。结果：阿塔瓦尔帕2548名居民中有2415人回答了问卷，1687人进行了囊虫病血清学检查。囊虫病血清阳性率为145/1,686(8.6%)。神经学检查证实有24名癫痫患者(粗患病率为每千人9.9人，经美国人口调整后为每千人10.8人)。经年龄、性别和养猪方式调整后，阳性血清学与癫痫密切相关(优势比(OR)为4.16；95%可信区间(CI)为1.6-11.2)。5例癫痫患者的CT表现与脑囊虫病相符，也比对照组更常见，但差异无统计学意义(5/19比1/19；p=0.125，McNemar检验)。结论：脑囊虫病与阿塔瓦尔帕地区三分之一的癫痫患者有关，可能是导致该人群癫痫比例过高的主要因素。
Purpose: To determine the prevalence of epilepsy and the role of neurocysticercosis in the occurrence of epilepsy in Atahualpa.Methods: We used a door-to-door survey to detect subjects with epileptic seizures, to collect a blood sample for determination of anticysticercal antibodies, and to evaluate social characteristics of the population, including household pig ownership. Neurologists examined suspected cases and a sample of negative individuals. Then patients with epilepsy, as well as age- and sex-matched controls, underwent a head computed tomography (CT) and a scalp EEG.Results: The questionnaire was answered by 2,415 of 2,548 residents of Atahualpa, and cysticercosis serology was performed in 1,687 consenting individuals. Cysticercosis seroprevalence was 145 (8.6%) per 1,686). Neurologic examination confirmed 24 patients with epilepsy (crude prevalence, 9.9 per 1,000 population, and 10.8 per 1,000 when adjusted to the United States population). After adjustment by age, sex, and pig raising, positive serology was strongly associated with epilepsy (odds ratio (OR), 4.16; 95% confidence interval (CI), 1.6-11.2). CT findings compatible with neurocysticercosis were found in five patients with epilepsy and also were more frequent than in controls, although this did not reach statistical significance (five of 19 vs. one of 19; p = 0.125, McNemar's test). Besides these five cases, three other patients with epilepsy had positive serology (one with a normal CT and two who did not have a CT).Conclusions: Neurocysticercosis is associated with one-third of cases of epilepsy in Atahualpa and may be a major contributory factor for the excess fraction of epilepsy seen in this population.