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;

Search for other papers by Fernando Nateros in
Current site
Google Scholar
PubMed
Close
,
Edith Saenz Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

Search for other papers by Edith Saenz in
Current site
Google Scholar
PubMed
Close
,
Herbert Saavedra Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

Search for other papers by Herbert Saavedra in
Current site
Google Scholar
PubMed
Close
,
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;

Search for other papers by Isidro Gonzales in
Current site
Google Scholar
PubMed
Close
,
E. Javier Pretell Hospital Nacional Alberto Sabogal, Callao, Peru;

Search for other papers by E. Javier Pretell in
Current site
Google Scholar
PubMed
Close
,
Erika Perez Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

Search for other papers by Erika Perez in
Current site
Google Scholar
PubMed
Close
,
Yesenia Castillo Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru

Search for other papers by Yesenia Castillo in
Current site
Google Scholar
PubMed
Close
,
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

Search for other papers by Javier A. Bustos in
Current site
Google Scholar
PubMed
Close
,
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

Search for other papers by Hector H. Garcia in
Current site
Google Scholar
PubMed
Close
, and
for the Cysticercosis Working Group in Peru
Restricted access

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.

    • Supplemental Materials (PDF 350.57 KB)

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.

  • 1.

    Bustos J , Gonzales I , Saavedra H , Handali S , Garcia HH , 2021. Neurocysticercosis. A frequent cause of seizures, epilepsy, and other neurological morbidity in most of the world. J Neurol Sci 427: 117527.

    • Search Google Scholar
    • Export Citation
  • 2.

    Fleury A , Carrillo-Mezo R , Flisser A , Sciutto E , Corona T , 2011. Subarachnoid basal neurocysticercosis: a focus on the most severe form of the disease. Expert Rev Anti Infect Ther 9: 123133.

    • Search Google Scholar
    • Export Citation
  • 3.

    Abanto J , Blanco D , Saavedra H , Gonzales I , Siu D , Pretell EJ , Bustos JA , Garcia HH , 2021. Mortality in parenchymal and subarachnoid neurocysticercosis. Am J Trop Med Hyg 105: 176180.

    • Search Google Scholar
    • Export Citation
  • 4.

    Marcin-Sierra M et al., 2017. Extraparenchymal neurocysticercosis: demographic, clinicoradiological, and inflammatory features. PLoS Negl Trop Dis 11: e0005646.

    • Search Google Scholar
    • Export Citation
  • 5.

    Fleury A , Dessein A , Preux P , Dumas M , Tapia G , Larralde C , Sciutto E , 2004. Symptomatic human neurocysticercosis: age, sex and exposure factors relating with disease heterogeneity. J Neurol 251: 830837.

    • Search Google Scholar
    • Export Citation
  • 6.

    Monteiro L , Almeida-Pinto J , Stocker A , Sampaio-Silva M , 1993. Active neurocysticercosis, parenchymal and extraparenchymal: a study of 38 patients. J Neurol 241: 1521.

    • Search Google Scholar
    • Export Citation
  • 7.

    Bazan R , Hamamoto Filho PT , Luvizutto GJ , Nunes HR , Odashima NS , Dos Santos AC , Elias Júnior J , Zanini MA , Fleury A , Takayanagui OM , 2016. Clinical symptoms, imaging features and cyst distribution in the cerebrospinal fluid compartments in patients with extraparenchymal neurocysticercosis. PLoS Negl Trop Dis 10: e0005115.

    • Search Google Scholar
    • Export Citation
  • 8.

    Nash TE , O’Connell EM , 2020. Subarachnoid neurocysticercosis: emerging concepts and treatment. Curr Opin Infect Dis 33: 339346.

  • 9.

    Rodriguez S , Dorny P , Tsang VCW , Pretell EJ , Brandt J , Lescano AG , Gonzalez AE , Gilman RH , Garcia HH ; Cysticercosis Working Group in Peru , 2009. Detection of Taenia solium antigens and anti–T. solium antibodies in paired serum and cerebrospinal fluid samples from patients with intraparenchymal or extraparenchymal neurocysticercosis. J Infect Dis 199: 13451352.

    • Search Google Scholar
    • Export Citation
  • 10.

    Arroyo G et al.; Cysticercosis Working Group in Peru , 2018. Antibody banding patterns of the enzyme-linked immunoelectrotransfer blot and brain imaging findings in patients with neurocysticercosis. Clin Infect Dis 66: 282288.

    • Search Google Scholar
    • Export Citation
  • 11.

    Serpa JA , Graviss EA , Kass JS , White AC , 2011. Neurocysticercosis in Houston, Texas: an update. Medicine (Baltimore) 90: 8186.

  • 12.

    Dixon HB , Lipscomb FM , 1961. Cysticercosis: an analysis and follow-up of 450 cases. London, UK: H.M. Stationery Office.

  • 13.

    Del Brutto OH , 2012. Neurocysticercosis among international travelers to disease‐endemic areas. J Travel Med 19: 112117.

  • 14.

    Murrieta I , Flores X , Osorio R , Kuschick Feher J , Carrillo-Mezo R , Fleury A , 2021. Natural history of extraparenchymal neurocysticercosis. Trans R Soc Trop Med Hyg 115: 12181225.

    • Search Google Scholar
    • Export Citation
  • 15.

    Nash TE , O’Connell EM , Hammoud DA , Wetzler L , Ware JM , Mahanty S , 2020. Natural history of treated subarachnoid neurocysticercosis. Am J Trop Med Hyg 102: 7889.

    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 311 311 56
Full Text Views 227 227 3
PDF Downloads 84 84 4
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save