Examining the Relationships Among Neurocysticercosis, Presenting Symptoms, & Stroke
Neurocysticercosis (NCC), a parasitic infection of the human central nervous system with the organism Taenia solium is an important, yet neglected, global public health problem causing preventable disability such as seizure and stroke in those infected. NCC symptoms vary widely, based upon the number and location of lesions, and can be difficult to identify and diagnose. NCC is a reportable disease in Los Angeles County. However, there is limited understanding of NCC disease burden in Los Angeles County due to reporting barriers.
This dissertation is presented in three papers. The first paper examines case reporting and demographics of probable NCC cases identified in a Los Angeles community hospital through review of computerized tomography (CT) brain scan reports performed during 2012 that describe evidence of lesions highly suggestive of NCC infection. The study identified 303 probable NCC cases and found that 7 of the 11 cases reported to Los Angeles County Department of Public Health in 2012 were from the study site.
The second paper describes the presenting symptoms and mortality data of identified probable NCC cases. The study found that 3.9% of cases presented with seizure upon admission to the hospital and that death occurred in 3.9% of cases. The most common presenting symptom was headache (24.7%).
The third paper analyzes the rate of prior and acute stroke in the 303 probable NCC cases. The study found that 28.3% had evidence of prior stroke and 13.2% had evidence of acute stroke on CT brain scan performed during their admission to the hospital. NCC infection was also shown to be statistically significant as an independent risk factor for acute stroke when other known stroke risk factors were controlled for. The odds of acute stroke for probable NCC-infected persons were nearly 25 times that of noninfected NCC persons in this study.
The research presented here improves the understanding of NCC disease burden in Los Angeles County, demonstrates differences in NCC presenting symptoms, and demonstrates that NCC infection is an independent risk factor for acute stroke.