Neurocysticercosis-related seizures in the post-partum period: two cases and a review of the literature

Neurocysticercosis, the infection of the CNS with larval cysts of Taenia solium, is a leading cause of seizures in low-income countries. The clinical presentation of neurocysticercosis is variable and depends on the number, size, and location of cysticerci, and on the immune response of the host. In...

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Bibliographic Details
Published in:The Lancet infectious diseases 2020-08, Vol.20 (8), p.e204-e214
Main Authors: Ursini, Tamara, Di Giacomo, Roberta, Caldrer, Sara, Angheben, Andrea, Zammarchi, Lorenzo, Filipponi, Stefania, Pizio, Nicola Renato, Bisoffi, Zeno, Buonfrate, Dora
Format: Article
Language:English
Subjects:
Asymptomatic
Breastfeeding & lactation
Calcification
Convulsions & seizures
Cysticercosis
Cysts
Drug dosages
Edema
Electroencephalography
Epilepsy
Health care
Immune response
Immune system
Infections
Infectious diseases
Literature reviews
Low income areas
Parenchyma
Patients
Postpartum period
Pregnancy
Seizures
Serology
Womens health
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Summary:Neurocysticercosis, the infection of the CNS with larval cysts of Taenia solium, is a leading cause of seizures in low-income countries. The clinical presentation of neurocysticercosis is variable and depends on the number, size, and location of cysticerci, and on the immune response of the host. In most patients, the affected site is the brain parenchyma, where cysts can precipitate seizures. Neurocysticercosis has seldom been described in pregnant women. In this Grand Round, we report two cases of pregnant women who immigrated to Italy from Bolivia and Ecuador, and who developed seizures in the early post-partum period, due to calcified parenchymal neurocysticercosis lesions. We discuss the complex interactions between neurocysticercosis and the immune system in pregnancy and the post-partum period. Building on this scenario, we propose practices for the management of neurocysticercosis in pregnancy and the post-partum period, highlighting important gaps in the literature that should be addressed.
ISSN:1473-3099
1474-4457
DOI:10.1016/S1473-3099(20)30240-1