Older Age in Subarachnoid Neurocysticercosis Reflects a Long Prepatent Period

Fernando Nateros Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru;
Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

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Edith Saenz Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

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Herbert Saavedra Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

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Isidro Gonzales Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;
Unidad de Investigación, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

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E. Javier Pretell Hospital Nacional Alberto Sabogal, Callao, Peru;

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Erika Perez Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

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Yesenia Castillo Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru

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Javier A. Bustos Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;
Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru

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Hector H. Garcia Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;
Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru

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for the Cysticercosis Working Group in Peru
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ABSTRACT.

Patients with subarachnoid neurocysticercosis (NCC) are usually older than those with parenchymal disease. Whether this difference reflects a prolonged presymptomatic period or a delay in diagnosis is not clear. From 408 eligible patients, we retrospectively compared the age at symptom onset in 140 patients diagnosed with parenchymal (pure viable or pure calcified) and subarachnoid NCC who had a confirmatory image available not more than 2 years after the beginning of symptoms. Patients with mixed (parenchymal and subarachnoid) NCC or those with parenchymal cysts at different stages (viable and/or degenerating and/or calcified) were not included. After controlling by sex and residence in rural endemic regions, the mean age at symptom onset in patients with subarachnoid disease was 13.69 years older than those with viable parenchymal disease. A long incubation period is a major contributing factor to older age at presentation in subarachnoid NCC, independent of delayed diagnosis or access to care.

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Author Notes

Address correspondence to Fernando Nateros, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, 15102 San Martín de Porres, Lima, Peru. E-mail: percy.nateros.b@upch.pe

Financial support: This study was partially supported by Fogarty International Center NIH training grant D43TW001140 and National Institute of Neurological Disorders and Stroke grant number U01NS086974.

Authors’ addresses: Fernando Nateros, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru, and Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, E-mail: percy.nateros.b@upch.pe. Edith Saenz, Herbert Saavedra, and Erika Perez, Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, E-mails: edith.saenz.h@upch.pe, hsaavedrapastor@hotmail.com, and erika.perez.p@upch.pe. Isidro Gonzales, Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, and Unidad de Investigación, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, E-mail: isidrogonzalesq@hotmail.com. E. Javier Pretell, Hospital Nacional Alberto Sabogal, Callao, Peru, E-mail: ejpretell@hotmail.com. Yesenia Castillo, Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mail: yesenia.castillo.b@upch.pe. Javier A. Bustos and Hector H. Garcia, Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, and Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: javier.bustos.p@upch.pe and hgarcia@jhsph.edu.

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