How frequent is the association of neurocysticercosis and mesial temporal lobe epilepsy with hippocampal sclerosis?

摘要

In an interesting article, Chandra et al. (2010) quoted us to support the view that the association of neurocysticercosis (NCC) and mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is rare. This is not our view. Instead, we believe that this association is rather frequent. NCC is endemic in the developing world, being a major cause of epilepsy worldwide (Garcia et al., 2005). Despite the fact that the epidemiology of the association of MTLE-HS with NCC is unknown, there are some clues regarding the real occurrence of this association. The prevalence of NCC plus MTLE-HS might be high in some world regions (Bianchin et al., 2005). In a cross-sectional study of 512 patients with refractory epilepsy, 281 (54.8%) of them had MTLE-HS and 104 (37.0% of the total of patients with MTLE-HS) presented MTLE-HS plus NCC. In comparison, the prevalence of NCC in patients with other epileptogenic lesions (cortical dysplasia, brain tumors, or gliosis) was only 15%, a significant difference (Velasco et al., 2006). Given the epidemiology of both diseases, if this association also occurs in other populations, then the prevalence of MTLE-HS plus NCC worldwide would be substantial.