Neurocisticercose I: evolução clínico-laboratorial de 151 casos

Takayanagui, Osvaldo M.

doi:10.1590/S0004-282X1990000100001

Resumos

A neurocisticercose é grave problema de saúde pública em nosso meio, representando 7,3% das internações e 2,7% dos atendimentos efetuados pela Disciplina de Neurologia da FMRP-USP, no período de 1979 a 1986. Foram selecionados 151 pacientes com o tempo de seguimento mínimo de 6 meses para o estudo da evolução clínico-laboratorial, tema raramente enfocado na literatura. Dos 82 pacientes que apresentaram crises epilépticas, 36,6% desenvolveram na evolução outras formas clínicas da NC. A associação de um segundo quadro neurológico foi observado em 55% dos 40 pacientes com a forma hipertensiva e em 19% dos 21 pacientes com a forma meningítica. Na forma epiléptica a presença de cistos na TC do crânio e/ou de anormalidades no LCR indica risco maior de desenvolvimento posterior de outras síndromes neurológicas. Não se verificaram diferenças significativas nos padrões de anormalidades destes exames nas demais formas clínicas. As lesões císticas na TC do crânio foram acompanhadas de anormalidades do LCR em 90,9%, principalmente a pleocitose e a positividade da reação de Weinberg. Em contraposição, esta proporção foi de apenas 26% naqueles com calcificações.

Neurocysticercosis is a serious public health problem in our midst, which accounted for 7.3% of the hospital admissions and 2.7% of all cases of the out patient clinic attendance of the Discipline of Neurology of the School of Medicine - Ribeirão Preto, São Paulo University, from 1979 to 1986. A total of 151 patients with a minimum follow-up of 6 months were selected for the present study including clinical and laboratory evolution, a topic which is rarely considered in the literature. The onset of the disease was characterized by: epileptic seizures in 82 patients (54.3%), increased intracranial pressure (ICP) in 40 (26,5%), meningitis in 21 (13.9%), headache in the absence of increased ICP or meningitic signs in 7 (4,6%), and spinal cord syndrome in 1 (0.6%). In the group with the epileptic form, 36.6% of the patients later developed other neurological syndromes, such as cysticercotic meningitis, mental disorders and increased ICP after a 6 to 7 years interval. In the group with the hypertensive form, 55% of the patients developed other manifestations during the period of evolution, especially meningitis and epileptic seizures, after a significantly shorter interval than for the epileptic form. In the meninsitic form, 19% of the patients showed a recurrence of the syndrome after a mean interval of 10.7 weeks: an additional 66.6% developed a combination with other syndromes, especially increased ICP and epileptic seizures. The death rate was 7.9%, the main cause being increased ICP (83.3%). When the abnormalities of the complementary tests were investigated in the various forms of clinical presentation in terms of their predictive value it was concluded that, in the epileptic form, the presence of cysts in CT scan and/or abnormalities in CSF indicates a greater risk of developing other neurologic syndromes. No significant differences in the patterns of abnormalities of these investigations were detected in the remaining clinical forms. Most cystic lesions detected by CT scan (90.9%) were associated with CSF abnormalities, especially pleocytosis and positive complement fixation test. Conversely, this proportion was only 26% in patients with calcifications.

Osvaldo M. Takayanagui

Resumo da Tese de Doutorado apresentada ao Departamento de Neuropisiquiatria e Psicologia Médica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP): Médico-Assistente do Hospital das Clínicas da FMRP-USP

RESUMO

A neurocisticercose é grave problema de saúde pública em nosso meio, representando 7,3% das internações e 2,7% dos atendimentos efetuados pela Disciplina de Neurologia da FMRP-USP, no período de 1979 a 1986. Foram selecionados 151 pacientes com o tempo de seguimento mínimo de 6 meses para o estudo da evolução clínico-laboratorial, tema raramente enfocado na literatura. Dos 82 pacientes que apresentaram crises epilépticas, 36,6% desenvolveram na evolução outras formas clínicas da NC. A associação de um segundo quadro neurológico foi observado em 55% dos 40 pacientes com a forma hipertensiva e em 19% dos 21 pacientes com a forma meningítica. Na forma epiléptica a presença de cistos na TC do crânio e/ou de anormalidades no LCR indica risco maior de desenvolvimento posterior de outras síndromes neurológicas. Não se verificaram diferenças significativas nos padrões de anormalidades destes exames nas demais formas clínicas. As lesões císticas na TC do crânio foram acompanhadas de anormalidades do LCR em 90,9%, principalmente a pleocitose e a positividade da reação de Weinberg. Em contraposição, esta proporção foi de apenas 26% naqueles com calcificações.

SUMMARY

Neurocysticercosis is a serious public health problem in our midst, which accounted for 7.3% of the hospital admissions and 2.7% of all cases of the out patient clinic attendance of the Discipline of Neurology of the School of Medicine - Ribeirão Preto, São Paulo University, from 1979 to 1986. A total of 151 patients with a minimum follow-up of 6 months were selected for the present study including clinical and laboratory evolution, a topic which is rarely considered in the literature. The onset of the disease was characterized by: epileptic seizures in 82 patients (54.3%), increased intracranial pressure (ICP) in 40 (26,5%), meningitis in 21 (13.9%), headache in the absence of increased ICP or meningitic signs in 7 (4,6%), and spinal cord syndrome in 1 (0.6%). In the group with the epileptic form, 36.6% of the patients later developed other neurological syndromes, such as cysticercotic meningitis, mental disorders and increased ICP after a 6 to 7 years interval. In the group with the hypertensive form, 55% of the patients developed other manifestations during the period of evolution, especially meningitis and epileptic seizures, after a significantly shorter interval than for the epileptic form. In the meninsitic form, 19% of the patients showed a recurrence of the syndrome after a mean interval of 10.7 weeks: an additional 66.6% developed a combination with other syndromes, especially increased ICP and epileptic seizures. The death rate was 7.9%, the main cause being increased ICP (83.3%). When the abnormalities of the complementary tests were investigated in the various forms of clinical presentation in terms of their predictive value it was concluded that, in the epileptic form, the presence of cysts in CT scan and/or abnormalities in CSF indicates a greater risk of developing other neurologic syndromes. No significant differences in the patterns of abnormalities of these investigations were detected in the remaining clinical forms. Most cystic lesions detected by CT scan (90.9%) were associated with CSF abnormalities, especially pleocytosis and positive complement fixation test. Conversely, this proportion was only 26% in patients with calcifications.

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Departamento de Neuropsiquiatria e Psicologia Médica, Faculdade de Medicina de Ribeirão Preto, USP - 14048 Ribeirão Preto SP - Brasil.

1 Alarcon T, Olivares L - Cisticercosis cerebral: manifestaciones clínicas en un medio de alta prevalência. Rev Invest Clin 27:209, 1975.
2 Arroyo-González M - Cisticercosis cerebral: aspecto clínico. Rev Med Hosp Gen (México) 21:611, 1958.
3. Arseni C, Cristescu A - Epilepsy due to cerebral cysticercosis. Epilesia 13:253, 1972.
4. Arseni C, Samitca DC - Cysticercosis of the brain. Br Med J 2:494, 1957.
5. Beltrán-Goftí P - Cysticercosis of the nervous system: clinical findings and treatment. J Neurosurg 19:641, 1962.
6. Brotto W - Aspectos neurológicos da cisticercose. Arq. Neuro-Psiquiat (São Paulo) 5:258, 1947.
7. Byrd SE, Locke GE, Biggers S, Percy AK - The computed tomographic appearance of cerebral cysticercosis in adults and children. Radiology 144:819, 1982.
8. Byrd SE, Percy AK, Locke GE, Smart-Abbey V - The parenchymal form of cerebral cysticercosis. Diagnostic Imaging 50:201, 1981.
9. Canelas HM - Neurocisticercose: incidência, diagnóstico e formas clínicas. Arq Neuro-Psiquiat (São Paulo) 20:1, 1962.
10. Canelas HM - Cisticercose do sistema nervoso central. Rev Med (São Paulo) 477:75, 1963.
11. De La Riva FI - Cisticercosis Cerebral. Vergara, Barcelona, 1957.
12. Dixon HBF, Hargreaves WH - Cysticercosis (Taenia solium): a further ten years'clinical study, covering 284 cases. Quart J Med 14:107, 1945.
13. Dixon HBF, Lipscomb FM - Cysticercosis: an analysis and follow-up of 450 cases. Privy Council, Med Res Council. Special Report Series 299. Her Majesty's Stationery Office, London, 1961.
14. Enzmann DR - Imaging of Infections and Inflammations of the Central Nervous System: Computed Tomography, Ultrasound, and Nuclear Magnetic Resonance. Raven Press, New York, 1984, pg 103.
15. Espinoza B, Flisser A, Plancarte A, Larralde C - Immunopdiagnosis of human cysticercosis: ELISA and immunoelectrophoresis. In Flisser A, Willms K, Laclette JP, Larralde C, Ridaura C, Beltrán F (eds): Cysticercosis: Present State of Knowledge and Perspectives. Academic Press, New York, 1982, pg 163.
16. Garcia-Ramos G, Rubio-Donnadieu F - Neurocysticercosis in the adult. In Palacios E, Rodriguez-Carbajal J, Taveras JM (eds): Cysticercosis of the Central Nervous System. Charles C. Thomas, Springfield, 1983, pg 63.
17. Grau E, Garrido F, Cañedo L - Calcification of the cysticerci of Taenia solium in the human brain. In Flisser A, Willms K, Laclette JP, Larralde C, Ridaura C, Beltrán F (eds): Cysticercosis: Present State of Knowledge and Perspectives. Academic Press, New York, 1982, pg 499.
18. Grisolia JS, Wiederholt WC - CNS cysticercosis. Arch Neurol 39:540. 1982.
19. Lamas E, Estevez J, Soto M, Obrador S - Computed axial tomography for the diagnosis of cerebral cysticercosis. Acta Neurochir 44:197, 1978.
20. Lange O - Síndrome liquórica da cisticercose encéfalo-meningéia. Rev Neurol Psiquiat (São Paulo) 6:35, 1940.
21. Lima JGC - Cisticercose encefálica: aspectos clínicos. Tese de Livre-Docência. Escola Paulista de Medicina, São Paulo, 1966.
22. Livramento JA - Síndrome do líquido cefalorraqueano na neurocisticercose: estudo crítico sobre a evolução da imunidade humoral. Tese de Livre-Docência. Faculdade de Medicina da Universidade de São Paulo, São Paulo, 1986.
23. Livramento JA, Costa JM, Machado LR, Nobreza JPS, Spina-França A - ELISA (IgG e IgM) no LCR e soro na neurocisticercose em tratamento com praziquantel. Arq Neuro-Psiquiat (São Paulo) 43:267, 1985.
24. Lombardo L - La cisticercosis cerebral en México: III. Diagnóstico. Gac Méd Méx 118:4, 1982.
25. Lombardo L - La cisticercosis cerebral en México. V. Conclusiones. Gac Méd Méx 118:15, 1982.
26. Lombardo L, Mateos JH - Cerebral cysticercosis in México. Neurology 11:824, 1961.
27. López-Hernández A - Clinical manifestations and seqüencial computed tomography scans of cerebral cysticercosis in childhood. Brain Dev 5:269, 1983.
28. Lopez-Hernandez A & Garaizar C - Manifestations of infantile cerebral cysticercosis. In Palácios E, Rodriguez-Carbaial J, Taveras JM (eds): Cysticercosis of the Central Nervous System. Charles C. Thomas, Springfield, 1983, pg 69.
29. Macias RS, Ordonez SM - Cisticercosis cerebral: diagnóstico clínico radiológlco y de laboratório; pronostico; analisis de 186 casos. Prensa Méd Méx 35:6, 1970.
30. Magalhães AEA - Reação de fixação do complemento para cisticercose no líquido cefaIorraquidiano: emprego de novo antígeno por método quantitativo. Arq Neuro-Psiquiat (São Paulo) 15:183. 1957.
31. McCormick GF, Zee C, Heiden J - Cysticercosis cerebri: review of 127 cases. Arch Neurol 39:534, 1982.
32. Mehringer CM, Hieshima G, Grinnell VS, Cobb SR, Zee C, Tsai FY - Radiologic considerations in neurocysticercosis. Bull Clin Neurosci 48:24, 1983.
33. Mervis B, Lotz JW - Computed tomography in parenchymatous cerebral cysticercosis. Clin Radiol 31:521, 1980.
34. Miller BL, Goldberg MA, Heiner D, Myers A - Cerebral cysticercosis: an overview. Bull Clin Neurosci 48:2, 1983.
35. Miller BL, Heiner D, Goldberg MA - The immunology of cerebral cysticercosis. Bull Clin Neurosci 48:18, 1983.
36. Minguetti G, Ferreira MVC - Computed tomography in neurocysticercosis. J Neurol Neurosurg Psychiat 46:936, 1983.
37. Nash TE, Neva FA - Recent advances in the diagnosis and treatment of cerebral cysticercosis. N Engl J Med 311:1492, 1984.
38. Nieto D - Cysticercosis of the nervous system; diagnosis by means of the spinal fluid complement fixation test. Neurology 6:725, 1956.
39 Nieto D - Historical notes on cysticercosis. In Flisser A, Willms K, Laclette JP, Larralde C, Ridaura C, Beltrán F (eds): Cysticercosis: Present State of Knowledge and Perspectives. Academic Press, New York, 1982, pg 1.
40. Nieto D - Cysticercosis of the nervous system: diagnosis by means of the spinal fluid complement fixation test. In Palacios E, Rodriguez-Carbaial J, Taveras JM (eds): Cysticercosis of the Central Nervous S:stem. Charles C. Thomas, Springfield, 1983, pg 55.
41. Pupo PP - Cysticercosis of the nervous system; clinical manifestations. Rev Neuro-psiquiat (Lima) 27:70, 1964.
42. Pupo PP, Cardoso W, Reis JB, Silva CP - Sobre a cisticercose encefálica; estudo clínico, anátomo-patológico, radiológico e do líquido céfalo-raqueano. Arq Assist Psicop São Paulo 10-11:3, 1945/1946,
43. Reis JB - Contribuição do laboratório para o diagnóstico da cisticercose encefálica. Rev Paulista Med 43:164, 1953.
44. Reis JB, Bei A, Reis-Filho JB, Nasser J - Líquido cefalorraquiano na cisticercose encefálica. Arq Neuro-Psiquiat (São Paulo) 37:113, 1979.
45. Reis-Filho JB, Reis JB, Bei A - Reação de fixação de complemento no diagnóstico da cisticercose. Neurobiologla (Recife) 48:227, 1985.
46. Rodriguez-Carbaial J, Boleaga-Durán B - Neuroradiology of human cysticercosis. In: Flisser A, Willms K, Laclette JP, Larralde C, Ridaura C, Beltrán F (eds): Cysticercosis: Present State of Knowledge and Perspectives. Academic Press, New York, 1982, pg 139.
47. Rodriguez-Carbajal J, Palacios E, Zee C - Neuroradiology of cysticercosis of the central nervous system. In Palácios E, Rodriguez-Carbajal J, Taveras JM (eds): Cysticercosis of the Central Nervous System. Charles C. Thomas, Springfield 1983, pg 101.
48. Rodriguez JC, Gutiérrez RA, Valdés OD, Dorfsman JF - The role of computed axial tomography in the diagnosis and treatment of brain inflammatory and parasitic lesions: our experience in Mexico. Neuroradiology 16:458, 1978.
49. Rosas N, Sotelo J, Nieto D - ELISA in the diagnosis of neurocysticercosis. Arch Neurol 43:353, 1986.
50. Schenone H - Resultados do tratamento de neurocisticercose com praziquantel. J Bras Med 45(supl):72. 1983.
51. Shanley JD, Jordan MC - Clinical aspects of CNS cysticercosis. Arch Intern Med 140:1309, 1980.
52. Sotelo J, Guerrero V, Rubio F - Neurocysticercosis: a new classification based on active and inactive forms; a study of 753 cases. Arch Intern Med 145:442, 1985.
53. Sotelo J, Torres B, Rubio-Donnadieu F, Escobedo F, Rodriguez-Carbajal J - Praziquantel in the treatment of neurocisticercosis: long-term follow-ulp. Neurology 35:752, 1985.
54. Spina-França A - Cisticercose do sistema nervoso central: considerações sobre 50 casos. Rev Paulista Med 48:59, 1956.
55. Spina-França A - Síndrome liquórica da neurocisticercose. Arq Neuro-Psiquiat (São Paulo) 19:307, 1961.
56. Spina-França A - Aspectos biológicos da neurocisticercose: alterações do líquido cefa-lorraquidiano. Arq Neuro-Psiquiat (São Paulo) 20:17, 1962.
57. Spina-França A, Rezende GL - Alteraciones del líquido cefalorraquídeo con el praziquantel. Sal Púb Méx 24:633, 1982.
58. Stepién L - Cerebral cysticercosis in Poland: clinical symptoms and operative results in 132 cases. J Neurosurg 19:505, 1962.
59. Takayanagui OM - Aspectos clínicos da neurocisticercose: análise de 500 casos. Dissertação de Mestrado. Faculdade de Medicina de Ribeirão Preto. Universidade de São Paulo, Ribeirão Preto, 1980.
60. Takayanagui OM, Jardim E - Aspectos clínicos da neurocisticercose: análise de 500 casos. Arq Neuro-Psiquiat (São Paulo) 41:50, 1983.
61. Torrealba G, Villar SD, Tagla P, Arriagada P, Kase CS - Cysticercosis of the central nervous system: clinical and therapeutic considerations. J Neurol Neurosurg Psychiat 47:784, 1984.
62. Trelles JO - Cerebral cysticercosis. Wld Neurol 2:488, 1961.
63. Trelles JO, Lazarte J - Cisticercosis cerebral: estudio clínico, histopatológico y para-sitológico. Rev Neuropsiquiat (Lima) 3:393, 1940.
64. Trétiakoff C, Pacheco e Silva AC - Contribuição para o estudo da cysticercose cerebral e em particular das lesões cerebrais à distância nesta affecção. Mem. Hosp. Juqueri 1:37, 1924.
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Neurocisticercose I. Evolução clínico-laboratorial de 151 casos

Neurocysticercosis: I. Clinical and laboratory evolution of 151 cases.

Datas de Publicação

Publicação nesta coleção
25 Maio 2011
Data do Fascículo
Mar 1990

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1 Alarcon T, Olivares L - Cisticercosis cerebral: manifestaciones clínicas en un medio de alta prevalência. Rev Invest Clin 27:209, 1975.

[2] 2 Arroyo-González M - Cisticercosis cerebral: aspecto clínico. Rev Med Hosp Gen (México) 21:611, 1958.

[3] 3. Arseni C, Cristescu A - Epilepsy due to cerebral cysticercosis. Epilesia 13:253, 1972.

[4] 4. Arseni C, Samitca DC - Cysticercosis of the brain. Br Med J 2:494, 1957.

[5] 5. Beltrán-Goftí P - Cysticercosis of the nervous system: clinical findings and treatment. J Neurosurg 19:641, 1962.

[6] 6. Brotto W - Aspectos neurológicos da cisticercose. Arq. Neuro-Psiquiat (São Paulo) 5:258, 1947.

[7] 7. Byrd SE, Locke GE, Biggers S, Percy AK - The computed tomographic appearance of cerebral cysticercosis in adults and children. Radiology 144:819, 1982.

[8] 8. Byrd SE, Percy AK, Locke GE, Smart-Abbey V - The parenchymal form of cerebral cysticercosis. Diagnostic Imaging 50:201, 1981.

[9] 9. Canelas HM - Neurocisticercose: incidência, diagnóstico e formas clínicas. Arq Neuro-Psiquiat (São Paulo) 20:1, 1962.

[10] 10. Canelas HM - Cisticercose do sistema nervoso central. Rev Med (São Paulo) 477:75, 1963.

[11] 11. De La Riva FI - Cisticercosis Cerebral. Vergara, Barcelona, 1957.

[12] 12. Dixon HBF, Hargreaves WH - Cysticercosis (Taenia solium): a further ten years'clinical study, covering 284 cases. Quart J Med 14:107, 1945.

[13] 13. Dixon HBF, Lipscomb FM - Cysticercosis: an analysis and follow-up of 450 cases. Privy Council, Med Res Council. Special Report Series 299. Her Majesty's Stationery Office, London, 1961.

[14] 14. Enzmann DR - Imaging of Infections and Inflammations of the Central Nervous System: Computed Tomography, Ultrasound, and Nuclear Magnetic Resonance. Raven Press, New York, 1984, pg 103.

[15] 15. Espinoza B, Flisser A, Plancarte A, Larralde C - Immunopdiagnosis of human cysticercosis: ELISA and immunoelectrophoresis. In Flisser A, Willms K, Laclette JP, Larralde C, Ridaura C, Beltrán F (eds): Cysticercosis: Present State of Knowledge and Perspectives. Academic Press, New York, 1982, pg 163.

[16] 16. Garcia-Ramos G, Rubio-Donnadieu F - Neurocysticercosis in the adult. In Palacios E, Rodriguez-Carbajal J, Taveras JM (eds): Cysticercosis of the Central Nervous System. Charles C. Thomas, Springfield, 1983, pg 63.

[17] 17. Grau E, Garrido F, Cañedo L - Calcification of the cysticerci of Taenia solium in the human brain. In Flisser A, Willms K, Laclette JP, Larralde C, Ridaura C, Beltrán F (eds): Cysticercosis: Present State of Knowledge and Perspectives. Academic Press, New York, 1982, pg 499.

[18] 18. Grisolia JS, Wiederholt WC - CNS cysticercosis. Arch Neurol 39:540. 1982.

[19] 19. Lamas E, Estevez J, Soto M, Obrador S - Computed axial tomography for the diagnosis of cerebral cysticercosis. Acta Neurochir 44:197, 1978.

[20] 20. Lange O - Síndrome liquórica da cisticercose encéfalo-meningéia. Rev Neurol Psiquiat (São Paulo) 6:35, 1940.

[21] 21. Lima JGC - Cisticercose encefálica: aspectos clínicos. Tese de Livre-Docência. Escola Paulista de Medicina, São Paulo, 1966.

[22] 22. Livramento JA - Síndrome do líquido cefalorraqueano na neurocisticercose: estudo crítico sobre a evolução da imunidade humoral. Tese de Livre-Docência. Faculdade de Medicina da Universidade de São Paulo, São Paulo, 1986.

[23] 23. Livramento JA, Costa JM, Machado LR, Nobreza JPS, Spina-França A - ELISA (IgG e IgM) no LCR e soro na neurocisticercose em tratamento com praziquantel. Arq Neuro-Psiquiat (São Paulo) 43:267, 1985.

[24] 24. Lombardo L - La cisticercosis cerebral en México: III. Diagnóstico. Gac Méd Méx 118:4, 1982.

[25] 25. Lombardo L - La cisticercosis cerebral en México. V. Conclusiones. Gac Méd Méx 118:15, 1982.

[26] 26. Lombardo L, Mateos JH - Cerebral cysticercosis in México. Neurology 11:824, 1961.

[27] 27. López-Hernández A - Clinical manifestations and seqüencial computed tomography scans of cerebral cysticercosis in childhood. Brain Dev 5:269, 1983.

[28] 28. Lopez-Hernandez A & Garaizar C - Manifestations of infantile cerebral cysticercosis. In Palácios E, Rodriguez-Carbaial J, Taveras JM (eds): Cysticercosis of the Central Nervous System. Charles C. Thomas, Springfield, 1983, pg 69.

[29] 29. Macias RS, Ordonez SM - Cisticercosis cerebral: diagnóstico clínico radiológlco y de laboratório; pronostico; analisis de 186 casos. Prensa Méd Méx 35:6, 1970.

[30] 30. Magalhães AEA - Reação de fixação do complemento para cisticercose no líquido cefaIorraquidiano: emprego de novo antígeno por método quantitativo. Arq Neuro-Psiquiat (São Paulo) 15:183. 1957.

[31] 31. McCormick GF, Zee C, Heiden J - Cysticercosis cerebri: review of 127 cases. Arch Neurol 39:534, 1982.

[32] 32. Mehringer CM, Hieshima G, Grinnell VS, Cobb SR, Zee C, Tsai FY - Radiologic considerations in neurocysticercosis. Bull Clin Neurosci 48:24, 1983.

[33] 33. Mervis B, Lotz JW - Computed tomography in parenchymatous cerebral cysticercosis. Clin Radiol 31:521, 1980.

[34] 34. Miller BL, Goldberg MA, Heiner D, Myers A - Cerebral cysticercosis: an overview. Bull Clin Neurosci 48:2, 1983.

[35] 35. Miller BL, Heiner D, Goldberg MA - The immunology of cerebral cysticercosis. Bull Clin Neurosci 48:18, 1983.

[36] 36. Minguetti G, Ferreira MVC - Computed tomography in neurocysticercosis. J Neurol Neurosurg Psychiat 46:936, 1983.

[37] 37. Nash TE, Neva FA - Recent advances in the diagnosis and treatment of cerebral cysticercosis. N Engl J Med 311:1492, 1984.

[38] 38. Nieto D - Cysticercosis of the nervous system; diagnosis by means of the spinal fluid complement fixation test. Neurology 6:725, 1956.

[39] 39 Nieto D - Historical notes on cysticercosis. In Flisser A, Willms K, Laclette JP, Larralde C, Ridaura C, Beltrán F (eds): Cysticercosis: Present State of Knowledge and Perspectives. Academic Press, New York, 1982, pg 1.

[40] 40. Nieto D - Cysticercosis of the nervous system: diagnosis by means of the spinal fluid complement fixation test. In Palacios E, Rodriguez-Carbaial J, Taveras JM (eds): Cysticercosis of the Central Nervous S:stem. Charles C. Thomas, Springfield, 1983, pg 55.

[41] 41. Pupo PP - Cysticercosis of the nervous system; clinical manifestations. Rev Neuro-psiquiat (Lima) 27:70, 1964.

[42] 42. Pupo PP, Cardoso W, Reis JB, Silva CP - Sobre a cisticercose encefálica; estudo clínico, anátomo-patológico, radiológico e do líquido céfalo-raqueano. Arq Assist Psicop São Paulo 10-11:3, 1945/1946,

[43] 43. Reis JB - Contribuição do laboratório para o diagnóstico da cisticercose encefálica. Rev Paulista Med 43:164, 1953.

[44] 44. Reis JB, Bei A, Reis-Filho JB, Nasser J - Líquido cefalorraquiano na cisticercose encefálica. Arq Neuro-Psiquiat (São Paulo) 37:113, 1979.

[45] 45. Reis-Filho JB, Reis JB, Bei A - Reação de fixação de complemento no diagnóstico da cisticercose. Neurobiologla (Recife) 48:227, 1985.

[46] 46. Rodriguez-Carbaial J, Boleaga-Durán B - Neuroradiology of human cysticercosis. In: Flisser A, Willms K, Laclette JP, Larralde C, Ridaura C, Beltrán F (eds): Cysticercosis: Present State of Knowledge and Perspectives. Academic Press, New York, 1982, pg 139.

[47] 47. Rodriguez-Carbajal J, Palacios E, Zee C - Neuroradiology of cysticercosis of the central nervous system. In Palácios E, Rodriguez-Carbajal J, Taveras JM (eds): Cysticercosis of the Central Nervous System. Charles C. Thomas, Springfield 1983, pg 101.

[48] 48. Rodriguez JC, Gutiérrez RA, Valdés OD, Dorfsman JF - The role of computed axial tomography in the diagnosis and treatment of brain inflammatory and parasitic lesions: our experience in Mexico. Neuroradiology 16:458, 1978.

[49] 49. Rosas N, Sotelo J, Nieto D - ELISA in the diagnosis of neurocysticercosis. Arch Neurol 43:353, 1986.

[50] 50. Schenone H - Resultados do tratamento de neurocisticercose com praziquantel. J Bras Med 45(supl):72. 1983.

[51] 51. Shanley JD, Jordan MC - Clinical aspects of CNS cysticercosis. Arch Intern Med 140:1309, 1980.

[52] 52. Sotelo J, Guerrero V, Rubio F - Neurocysticercosis: a new classification based on active and inactive forms; a study of 753 cases. Arch Intern Med 145:442, 1985.

[53] 53. Sotelo J, Torres B, Rubio-Donnadieu F, Escobedo F, Rodriguez-Carbajal J - Praziquantel in the treatment of neurocisticercosis: long-term follow-ulp. Neurology 35:752, 1985.

[54] 54. Spina-França A - Cisticercose do sistema nervoso central: considerações sobre 50 casos. Rev Paulista Med 48:59, 1956.

[55] 55. Spina-França A - Síndrome liquórica da neurocisticercose. Arq Neuro-Psiquiat (São Paulo) 19:307, 1961.

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