Epilepsy, cysticercosis, and toxocariasis

Abstract

<b><i><i>Objective:</i></i></b> To assess the relationship between epilepsy and infection with <i>Taenia solium</i> and <i>Toxocara canis</i> with a case-control study, in the rural area of the Cordillera Province, Bolivia. <b><i><i>Methods:</i></i></b> A preliminary two-phase door-to-door prevalence survey determined the prevalence of epilepsy and identified cases and control subjects. At least two control subjects per case were selected, matching on sex, age, and community of residence. Cases and control subjects were assessed serologically for antibodies against <i>T. canis</i> by ELISA and against <i>T. solium</i> by enzyme-linked immunoelectrotransfer blot (EITB). <b><i><i>Results:</i></i></b> The prevalence survey found 130 confirmed cases of epilepsy, of which 113 were eligible for the case-control study (59 partial seizures and 54 generalized seizures). Two hundred thirty-three control subjects were selected. Multivariable analysis for a matched case-control study was carried out. There was an association between EITB positivity for <i>T. solium</i> and epilepsy with an OR of 1.85 (95% CI 0.99 to 3.4) for all cases. A stronger association was found in those with partial epilepsy with a late onset of disease (15 years and older), where the OR was 3.66 (95% CI 1.10 to 12.10). A positive association was also found with <i>T. canis</i> for all cases with an OR of 2.70 (95% CI 1.41 to 5.19). This increased for those with late-onset partial epilepsy to an OR of 18.22 (95% CI 2.10 to 158.10). <b><i><i>Conclusion:</i></i></b> This finding suggests that both neurocysticercosis and toxocariasis may in part explain the higher prevalence of epilepsy, particularly partial epilepsy, in developing countries.