Neurocysticercosis and epilepsy.

Introduction and Epidemiology Neurocysticercosis (NCC) is defined as a nervous system infection by the larval stage of Taenia solium. NCC is the most common parasitic disease of the nervous system. It accounts for about 50,000 deaths per year and many times this number of people with active epilepsy (1, 2). The disease is endemic in Central and South America, sub-Saharan Africa, and in some regions of the Far East, including the Indian subcontinent, Indonesia, and China. It is rare in Europe, in North America (with the exception of the southwest United States), Australia, Japan, and New Zealand, except among immigrants. It is non-existent in Israel and the Muslim countries of Africa and Asia (Figure 1) (1, 3). With increased travel to disease-endemic areas and the migration of tapeworm carriers or people infected with the disease, NCC is becoming increasingly prevalent in industrialized countries, particularly the United States (4). In a recent systematic review, the frequency of NCC in people with epilepsy was found to have a large variability. The authors selected a total 565 articles from PubMed and 23 international databases, from January 1, 1990, to June 1, 2008 (5). The pooled estimate for this population was found to be 29% (95% confidence interval [CI]: 22.9–35.5%).