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From the Neuroepidemiology Section, Neurology Service, Department of Veterans Affairs Medical Center, Washington, DC; and Department of Neurology, Georgetown University Medical School, Washington, DC.
Address correspondence and reprint requests to Dr. Mitchell T. Wallin, Chief, Neuroepidemiology, Asst. Professor of Neurology, Georgetown University School of Medicine, VAMC-Neurology Service, #127, 50 Irving Street, NW, Washington, DC 20007; e-mail: mitchell.wallin{at}med.va.gov
Objective: To review published clinical studies on neurocysticercosis (NCC) in the United States over the past two decades and comment on epidemiologic trends and treatment.
Methods: This review is based on a search of the literature citing NCC cases diagnosed in the United States utilizing PUBMED for the years 1980 through early 2004. Case series, case reports, epidemiologic studies, and treatment of NCC were evaluated.
Results: A total of 1,494 patients with NCC were reported in the United States among large case series (n > 20) between 1980 and early 2004. Common onset symptoms for these patients included seizures (66%), hydrocephalus (16%), and headaches (15%). The majority presented with parenchymal NCC (91%), with the remainder having ventricular cysts (6%), subarachnoid cysts (2%), and spinal cysts (0.2%). A total of 76 cases of NCC were likely acquired within the United States during the period of this review. A higher risk for acquiring NCC has been documented in patients who have traveled to endemic regions, are of Hispanic ethnicity, and have contact with Taenia solium tapeworm carriers.
Conclusions: An increasing number of NCC cases have been reported in the US literature over the past 50 years, suggesting that the prevalence of this disease may be on the rise. Because neurologists are often involved with the diagnosis and management of NCC in the United States, it is important that they become familiar with this disorder, as they will play an important role in efforts to control the disease.
Received December 13, 2003. Accepted in final form June 2, 2004.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the November 9 issue to find the title link for this article.
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Neurology 2004 63: 1550-1551.
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