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Neurocysticercotic Calcifications and Hippocampal Sclerosis: A Case-Control Study.

de Oliveira Taveira M, Morita ME, Yasuda CL, Coan AC, Secolin R, Luiz Cunha da Costa A, Cendes F - PLoS ONE (2015)

Bottom Line: CNLs were found in 31.09% of cases and in 11.32% of controls (p<0.001).However, when we compared MTLE-HS versus other epilepsies versus controls we confirmed that CNLs were associated with MTLE-HS (OR = 11.27, 95%CI = 4.73-26.85; p<0.001) but other epilepsies were not.These findings raise the possibility of neurocysticercosis playing a role in the pathophysiology of MTLE-HS and need further confirmation in other series.

View Article: PubMed Central - PubMed

Affiliation: School of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil.

ABSTRACT

Objective: The exact role of calcified neurocysticercotic lesions (CNLs) in epilepsy is yet unknown and controversial. Although the relationship between CNLs, epilepsy and mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) has already been addressed, to our knowledge, no study has actually provided strong statistical evidence, nor reported the ODDS ratio for these associations. Therefore, we designed this case-control study to assess the likelihood of having MTLE-HS versus other forms of epilepsy in the presence of CNLs.

Methods: In this case-control study we included 119 consecutive patients with epilepsy and 106 disease controls (headache) with previous CT scans. We subdivided cases into MTLE-HS and other epilepsies. We used brain CT scans to define presence or absence of CNLs. After exploratory analyses, we used logistic regression to analyze the association between CNLs, epilepsy subgroups and disease controls.

Results: CNLs were found in 31.09% of cases and in 11.32% of controls (p<0.001). The initial analysis comparing epilepsy versus controls revealed a significant association between CNLs and epilepsy (OR = 5.32; 95%CI = 2.43-11.54; p<0.001). However, when we compared MTLE-HS versus other epilepsies versus controls we confirmed that CNLs were associated with MTLE-HS (OR = 11.27, 95%CI = 4.73-26.85; p<0.001) but other epilepsies were not. We found no difference in the CNLs load and no difference in the location of the CNLs when we compared patients with MTLE-HS, other epilepsies and disease controls.

Significance: The inclusion of controls allowed us to estimate the likelihood of having epilepsy in the presence of CNLs. We found that patients with CNLs were 11 times more likely to have MTLE-HS; however, the presence of CNLs did not change the odds of having other types of epilepsy. These findings raise the possibility of neurocysticercosis playing a role in the pathophysiology of MTLE-HS and need further confirmation in other series.

No MeSH data available.


Related in: MedlinePlus

Location of neurocisticercotic calcifications in each group.This graph shows the percentage of subjects with calcifications located in the temporal lobe (Temporal), outside the temporal lobe (extratemporal) and unknown in each subgroups (MTLE-HS, other epilepsies, disease controls). There were no significant group differences considering the presence of calcifications in the temporal lobes. (p = 0.58) MTLE-HS = Mesial temporal lobe epilepsy with hippocampal sclerosis.
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pone.0131180.g003: Location of neurocisticercotic calcifications in each group.This graph shows the percentage of subjects with calcifications located in the temporal lobe (Temporal), outside the temporal lobe (extratemporal) and unknown in each subgroups (MTLE-HS, other epilepsies, disease controls). There were no significant group differences considering the presence of calcifications in the temporal lobes. (p = 0.58) MTLE-HS = Mesial temporal lobe epilepsy with hippocampal sclerosis.

Mentions: In this sub-analysis, we included only cases and controls with CNLs and divided them in 3 groups: MTLE-HS (n = 28), other epilepsies (n = 9) and controls (n = 12). We analyzed whether there were any differences in location of CNLs (temporal, extratemporal, unknown) amongst those 3 groups. We did not find a significant difference (p = 0.58) in CNLs location between them as seen in Fig 3.


Neurocysticercotic Calcifications and Hippocampal Sclerosis: A Case-Control Study.

de Oliveira Taveira M, Morita ME, Yasuda CL, Coan AC, Secolin R, Luiz Cunha da Costa A, Cendes F - PLoS ONE (2015)

Location of neurocisticercotic calcifications in each group.This graph shows the percentage of subjects with calcifications located in the temporal lobe (Temporal), outside the temporal lobe (extratemporal) and unknown in each subgroups (MTLE-HS, other epilepsies, disease controls). There were no significant group differences considering the presence of calcifications in the temporal lobes. (p = 0.58) MTLE-HS = Mesial temporal lobe epilepsy with hippocampal sclerosis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4488485&req=5

pone.0131180.g003: Location of neurocisticercotic calcifications in each group.This graph shows the percentage of subjects with calcifications located in the temporal lobe (Temporal), outside the temporal lobe (extratemporal) and unknown in each subgroups (MTLE-HS, other epilepsies, disease controls). There were no significant group differences considering the presence of calcifications in the temporal lobes. (p = 0.58) MTLE-HS = Mesial temporal lobe epilepsy with hippocampal sclerosis.
Mentions: In this sub-analysis, we included only cases and controls with CNLs and divided them in 3 groups: MTLE-HS (n = 28), other epilepsies (n = 9) and controls (n = 12). We analyzed whether there were any differences in location of CNLs (temporal, extratemporal, unknown) amongst those 3 groups. We did not find a significant difference (p = 0.58) in CNLs location between them as seen in Fig 3.

Bottom Line: CNLs were found in 31.09% of cases and in 11.32% of controls (p<0.001).However, when we compared MTLE-HS versus other epilepsies versus controls we confirmed that CNLs were associated with MTLE-HS (OR = 11.27, 95%CI = 4.73-26.85; p<0.001) but other epilepsies were not.These findings raise the possibility of neurocysticercosis playing a role in the pathophysiology of MTLE-HS and need further confirmation in other series.

View Article: PubMed Central - PubMed

Affiliation: School of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil.

ABSTRACT

Objective: The exact role of calcified neurocysticercotic lesions (CNLs) in epilepsy is yet unknown and controversial. Although the relationship between CNLs, epilepsy and mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) has already been addressed, to our knowledge, no study has actually provided strong statistical evidence, nor reported the ODDS ratio for these associations. Therefore, we designed this case-control study to assess the likelihood of having MTLE-HS versus other forms of epilepsy in the presence of CNLs.

Methods: In this case-control study we included 119 consecutive patients with epilepsy and 106 disease controls (headache) with previous CT scans. We subdivided cases into MTLE-HS and other epilepsies. We used brain CT scans to define presence or absence of CNLs. After exploratory analyses, we used logistic regression to analyze the association between CNLs, epilepsy subgroups and disease controls.

Results: CNLs were found in 31.09% of cases and in 11.32% of controls (p<0.001). The initial analysis comparing epilepsy versus controls revealed a significant association between CNLs and epilepsy (OR = 5.32; 95%CI = 2.43-11.54; p<0.001). However, when we compared MTLE-HS versus other epilepsies versus controls we confirmed that CNLs were associated with MTLE-HS (OR = 11.27, 95%CI = 4.73-26.85; p<0.001) but other epilepsies were not. We found no difference in the CNLs load and no difference in the location of the CNLs when we compared patients with MTLE-HS, other epilepsies and disease controls.

Significance: The inclusion of controls allowed us to estimate the likelihood of having epilepsy in the presence of CNLs. We found that patients with CNLs were 11 times more likely to have MTLE-HS; however, the presence of CNLs did not change the odds of having other types of epilepsy. These findings raise the possibility of neurocysticercosis playing a role in the pathophysiology of MTLE-HS and need further confirmation in other series.

No MeSH data available.


Related in: MedlinePlus