Definition and Characterization of the Contribution of Neurocysticercosis to Seizure Burden in Endemic Areas. (360G-Wellcome-091077_Z_09_Z)

The larvae of Taenia solium commonly invades the human brain causing neurocysticercosis (NCC). Studies suggest that NCC is the most important factor associated with acquired epilepsy in developing countries and probably in the world, and thus an important public health problem. This project will assess the contribution of NCC to seizure burden both in field and hospital conditions, with particular emphasis in the study of symptomatic perilesional edema around calcified brain larvae. This phenome non is likely to be a significant contributor to neurological morbidity in endemic regions. The proposed fellowship program is composed of four studies: 1) A series of community-based surveys and active surveillance to monitor changes in seizure incidence following a massive control intervention in a previously endemic region. 2) Field-based study to compare the prevalence of peri-calcification brain edema in individuals with and without recent neurological symptoms; 3) Hospital-b ased cohort study to gather a population with symptomatic calcified NCC, to further characterize peri-calcification edema and frame a population for a treatment trial; and 4) A clinical trial in individuals with symptomatic peri-calcification edema, comparing acetazolamide or steroids to no treatment in terms of reducing the likelihood of symptomatic relapses without increased risks of drug side effects.