Abstract Details

Title Increased Prevalence of Lacunar Strokes and Severe White Matter Disease in Patients with Neurocysticercosis (NCC)

Topic Infections/AIDS/Prion Disease

Presentation(s) P04 - (-)

Poster/Presentation
Number 010

Objective

Background BACKGROUND: Human NCC is the main cause of epilepsy in developing countries. Small series and case reports have linked NCC and strokes but Azad et al. found that NCC was not linked to intracranial disease (JNNP 2003;74:359).

Design/Methods DESIGN/METHODS: We evaluated all medical records from patients who 1. had a 64-channel multislice Head CT 2. seen at the Emergency Room, Hospital Regional Unimed from 3-7/2012 (largest private tertiary hospital, city of Fortaleza). Only patients ?18 and inhabitants of the state of Ceara, Brazil were included. We compared the groups with descriptive statistics, Pearson Chi-square, Fischer exact test and logistic regression analysis.

Results RESULTS: 1016 patients were studied. Mean age was 55.7±0.7 years, 56.7% were women, 3.1% lived outside the metropolitan area of Fortaleza, 98.9% had health insurance (42.6% had the most expensive). Most Head CTs were ordered for evaluation of head trauma (35.6%), headache (24.9%) and strokes (17.2%). Definite NCC (at least 2 lesions) was evidenced in 2.7%(0.2% had active disease). In additional 13.8%, NCC could not be ruled out by imaging (single intracerebral or subarachnoid calcifications). Patients with NCC were more likely to have epilepsy (PR=4.8,CI=1.02-22.7). Intracerebral hemorrhage was present in 2.4%, large hemispheric in 3.1% and lacunar strokes in 16.3%. Lacunar strokes and severe white matter disease were more prevalent in patients with NCC [P<0.05, PR=2.3 (CI=1.01-8.94) and 2.79 (CI= 1.05-7.39), respectively]. After adjusting for age and sex (regression analysis), NCC was still associated with a higher percentage of lacunar strokes. Cava (septum pellucidum, vergae or interpositi) were not more prevalent in NCC patients.

Conclusions CONCLUSIONS: NCC (especially residual chronic forms) is not rare in high socioeconomic status patients from Fortaleza. This is the first large study to link NCC, lacunar strokes and severe white matter disease.

Authors/Disclosures
Francisco De Assis Gondim, MD, PhD, MSc, FAAN (Universidade Federal Do Ceara) PRESENTER	No disclosure on file
Paulo Marcelo G. Sales	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Florian P. Thomas, MD, PhD, MA, FAAN (Hackensack Meridian Health)	Dr. Thomas has received personal compensation for serving as an employee of Hackensack Meridian Health. Dr. Thomas has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MND. Dr. Thomas has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Spinal Cord Medicine. Dr. Thomas has a non-compensated relationship as a Board Member, Metro New Jersey with National MS Society that is relevant to AAN interests or activities. Dr. Thomas has a non-compensated relationship as a Board Member with American Paraplegia Society that is relevant to AAN interests or activities.
Olga Ciccarelli, MD, PhD, FRCP (UCL Institute of Neurology)	Prof. Ciccarelli has received personal compensation in the range of $0-$499 for serving as a Consultant for Lundebeck. Prof. Ciccarelli has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Prof. Ciccarelli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Prof. Ciccarelli has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck. Prof. Ciccarelli has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEUROLOGY Journal.

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